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https://www.readbyqxmd.com/read/28645191/how-effective-is-algorithm-guided-treatment-for-depressed-inpatients-results-from-the-randomized-controlled-multicenter-german-algorithm-project-3-trial
#1
Mazda Adli, Katja Wiethoff, Thomas C Baghai, Robert Fisher, Florian Seemüller, Gregor Laakmann, Peter Brieger, Joachim Cordes, Jaroslav Malevani, Gerd Laux, Iris Hauth, Hans-Jürgen Möller, Klaus-Thomas Kronmüller, Michael N Smolka, Peter Schlattmann, Maximilian Berger, Roland Ricken, Thomas J Stamm, Andreas Heinz, Michael Bauer
Background: Treatment algorithms are are considered as key to improve outcomes by enhancing the quality of care. This is the first randomized controlled study to evalutate the clinical effect of algorithm-guided treatment in inpatients with major depressive disorder (MDD). Methods: Inpatients, aged 18-70 years with MDD from 10 German psychiatric departments were randomized to 5 different treatment arms (from 2000 to 2005), three of which were standardized stepwise drug treatment algorithms (ALGO)...
June 22, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28644587/recent-trends-in-vaginal-birth-after-caesarean-section
#2
A Brick, R Layte, M Farren, R Mahony, M J Turner
In developed countries, caesarean section (CS) rates continue to escalate and in Ireland nearly one in three women are now delivered by CS. The purpose of this study was to compare the management of women after one previous CS in two large Dublin maternity hospitals with the management in two other well-resourced countries. Data were analysed for Dublin, Massachusetts in the United States, and Hesse in Germany. It was found that since 1990, the CS rate in Dublin has increased by much more than in the other areas...
December 12, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28644300/breathlessness-in-the-primary-care-setting
#3
Noel Baxter
PURPOSE OF REVIEW: Breathlessness is a high-volume problem with 10% of adults experiencing the symptom daily placing a heavy burden on the health and wider economy. As it worsens, they enter the specialist and hospital-based symptom services where costs quickly escalate and people may find themselves in a place not of their choosing. For many, their care will be delivered by a disease or organ specialist and can find themselves passing between physicians without coordination for symptom support...
July 20, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28644180/mucosal-healing-in-clinical-practice-a-single-center-pediatric-ibd-experience
#4
Savini L Santha, Prabhu R Shankar, Anqi Pan, Bess Schoen, Subra Kugathasan, Cary G Sauer
BACKGROUND: Mucosal healing (MH) is associated with improved clinical outcomes in patients with Crohn's disease (CD) and ulcerative colitis (UC). MH as a target for treatment has been suggested, although there is little pediatric data. The goal of this study was to evaluate MH in clinical practice in pediatric patients with inflammatory bowel disease in clinical remission. METHODS: A retrospective review of electronic health record data was performed on all patients with CD or UC who underwent at least 2 colonoscopies from 2010 through 2016...
June 20, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28643293/-why-is-a-combination-of-basal-insulin-with-a-glp-1-receptor-agonist-useful-in-many-patients-with-type-2-diabetes
#5
Michael Nauck, Birgit Wilhelm
BACKGROUND: In 2015, the combination of basal insulin and GLP-1 receptor agonist (RA) was incorporated into the guideline recommendations for type 2 diabetes as an option for the last escalation step. The two antidiabetics to be injected subcutaneously are complementary regarding their respective main effects and limitations. Basal insulin is predominantly active between meals and in the fasting state, whereas the main action of GLP-1 RA consists in preventing an excessive postprandial blood glucose increase...
June 2017: MMW Fortschritte der Medizin
https://www.readbyqxmd.com/read/28643112/a-retrospective-study-of-antibiotic-de-escalation-in-patients-with-ventilator-associated-pneumonia-in-malaysia
#6
Rahela Ambaras Khan, Zoriah Aziz
Background Antibiotic de-escalation is an important strategy to conserve the effectiveness of broad-spectrum antibiotics. However, the outcome of this strategy for the treatment of ventilator-associated pneumonia (VAP) has not been widely studied in developing countries. Objectives To evaluate the outcome on intensive care unit (ICU) mortality, 28 days mortality, and length of ICU stay among VAP patients who receive de-escalation therapy. Setting This study was conducted in an ICU of a Malaysian public hospital...
June 22, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28643017/safety-and-efficacy-of-daratumumab-in-japanese-patients-with-relapsed-or-refractory-multiple-myeloma-a-multicenter-phase-1-dose-escalation-study
#7
Shinsuke Iida, Kenshi Suzuki, Shigeru Kusumoto, Masaki Ri, Nobuhiro Tsukada, Yu Abe, Masayuki Aoki, Mitsuo Inagaki
Safety, efficacy, and pharmacokinetics (PK) of daratumumab as a monotherapy were investigated in Japanese patients with relapsed/refractory multiple myeloma (MM). This multicenter, dose-escalation study included patients (age ≥20 years) with ≥2 prior therapies. Daratumumab was administered intravenously: 8 mg/kg (n = 4) and 16 mg/kg (n = 5). The primary endpoint was safety. Secondary endpoints included objective response, overall response rate (ORR), progression-free survival (PFS), PK, and immunogenicity...
June 22, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28642891/safety-tolerability-of-the-anti-semaphorin-4d-antibody-vx15-2503-in-a-randomized-phase-1-trial
#8
Christopher LaGanke, Lawrence Samkoff, Keith Edwards, Lily Jung Henson, Pavle Repovic, Sharon Lynch, Lael Stone, David Mattson, Aaron Galluzzi, Terrence L Fisher, Christine Reilly, Laurie A Winter, John E Leonard, Maurice Zauderer
OBJECTIVE: To evaluate the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of VX15/2503 in a randomized, single-dose, dose-escalation, double-blind, placebo-controlled study enrolling adult patients with MS. METHODS: Single IV doses of VX15/2503 or placebo were administered. Ten patients each were randomized (4:1 randomization ratio) into 5 ascending dose cohorts of 1, 3, 6, 10, or 20 mg/kg. Safety, immunogenicity, PK/PD, MRI, ECG, and lymphocyte subset levels were evaluated...
July 2017: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/28642831/treatment-of-hypochondriasis-in-two-schizophrenia-patients-using-clozapine
#9
Antonio Tundo, Luca Proietti, Rocco de Filippis
Hypochondriasis (HYPO), an obsessive-compulsive spectrum disorder, is frequent in patients with schizophrenia (SCH) (20%), especially among those treated with clozapine (36.7%). Treatment options for OCS/OCD in patients under clozapine (CLZ) include combining clozapine with amisulpride/aripiprazole or a mood stabilizer, augmenting clozapine with a serotoninergic reuptake inhibitor, adding cognitive behavioural therapy, and gradually reducing dosage. No treatments have been proposed for HYPO in patients using clozapine so we examine these options in 2 cases and report the results...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28642620/pomalidomide-bortezomib-and-low-dose-dexamethasone-in-lenalidomide-refractory-and-proteasome-inhibitor-exposed-myeloma
#10
P G Richardson, C C Hofmeister, N S Raje, D S Siegel, S Lonial, J Laubach, Y A Efebera, D H Vesole, A K Nooka, J Rosenblatt, D Doss, M H Zaki, A Bensmaine, J Herring, Y Li, L Watkins, M S Chen, K C Anderson
This phase 1 dose-escalation study evaluated pomalidomide, bortezomib (subcutaneous (SC) or intravenous (IV)) and low-dose dexamethasone (LoDEX) in lenalidomide-refractory and proteasome inhibitor-exposed relapsed or relapsed and refractory multiple myeloma (RRMM). In 21-day cycles, patients received pomalidomide (1-4 mg days 1-14), bortezomib (1-1.3 mg/m(2) days 1, 4, 8 and 11 for cycles 1-8; days 1 and 8 for cycle ⩾9) and LoDEX. Primary endpoint was to determine the maximum tolerated dose (MTD). Thirty-four patients enrolled: 12 during escalation, 10 in the MTD IV bortezomib cohort and 12 in the MTD SC bortezomib cohort...
June 2, 2017: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/28640871/nomogram-to-predict-rectal-toxicity-following-prostate-cancer-radiotherapy
#11
Jean-Bernard Delobel, Khemara Gnep, Juan David Ospina, Véronique Beckendorf, Ciprian Chira, Jian Zhu, Alberto Bossi, Taha Messai, Oscar Acosta, Joël Castelli, Renaud de Crevoisier
BACKGROUND: To identify predictors of acute and late rectal toxicity following prostate cancer radiotherapy (RT), while integrating the potential impact of RT technique, dose escalation, and moderate hypofractionation, thus enabling us to generate a nomogram for individual prediction. METHODS: In total, 972 patients underwent RT for localized prostate cancer, to a total dose of 70 Gy or 80 Gy, using two different fractionations (2 Gy or 2.5 Gy/day), by means of several RT techniques (3D conformal RT [3DCRT], intensity-modulated RT [IMRT], or image-guided RT [IGRT])...
2017: PloS One
https://www.readbyqxmd.com/read/28640686/prevalence-of-financial-fraud-and-scams-among-older-adults-in-the-united-states-a-systematic-review-and-meta-analysis
#12
David Burnes, Charles R Henderson, Christine Sheppard, Rebecca Zhao, Karl Pillemer, Mark S Lachs
BACKGROUND: The financial exploitation of older adults was recently recognized by the Centers for Disease Control and Prevention as a serious public health problem. Knowledge of the prevalence of elder financial exploitation is mostly limited to the category of financial abuse, which occurs in relationships involving an expectation of trust. Little is known about the other major category of elder financial exploitation-elder financial fraud and scams, which is perpetrated by strangers...
June 22, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28639759/-diabetes-mellitus-secondary-to-an-endocrine-pathology-when-to-think-about-it
#13
Nathalie Rouiller, François R Jornayvaz
An endocrine disease can be associated with glucose intolerance or diabetes mellitus, and the latter can falsely be considered as type 2 diabetes. Glycemic imbalance can be a direct or indirect consequence of excessive hormone production. Endocrine diseases such as acromegaly, Cushing's syndrome and pheochromocytoma can increase glucose production and cause insulin resistance. Hyperthyroidism, hyperaldosteronism, glucagonoma and somatostatinoma lead to hyperglycemia by other physiopathological mechanisms detailed in this article...
May 31, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28639698/definitional-elasticity-in-the-measurement-of-intergenerational-continuity-in-substance-use
#14
Thomas A Loughran, Pilar Larroulet, Terence P Thornberry
Increasingly, three generation studies have investigated intergenerational (IG) continuity and discontinuity in substance use and related problem behaviors. However, surprisingly little attention has been paid to the conceptual definition of continuity or to different types of discontinuity (resilience and escalation) or to measurement sensitivity, which affects not only the magnitudes of observed continuity but also factors that correlate with this linkage. This study uses longitudinal data on 427 parent-child dyads from the Rochester IG Study to study continuity and discontinuity in substance use over ages 14-18...
June 22, 2017: Child Development
https://www.readbyqxmd.com/read/28639001/sanguinate%C3%A2-pegylated-carboxyhemoglobin-bovine-improves-cerebral-blood-flow-to-vulnerable-brain-regions-at-risk-of-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage
#15
Rajat Dhar, Hemant Misra, Michael N Diringer
BACKGROUND: Delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) has been linked to focal reductions in cerebral blood flow (CBF) and microvascular impairments in oxygen delivery. Effective therapies that restore flow and oxygen transport to vulnerable brain regions are currently lacking. SANGUINATE is a dual-action carbon monoxide-releasing and hemoglobin-based oxygen transfer agent with efficacy in animal models of focal brain ischemia and tolerability in patients with sickle cell disease...
June 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28637176/dissociation-of-striatal-dopamine-and-tyrosine-hydroxylase-expression-from-aging-related-motor-decline-evidence-from-calorie-restriction-intervention
#16
Michael F Salvatore, Jennifer Terrebonne, Mark A Cantu, Tamara R McInnis, Katy Venable, Parker Kelley, Ella A Kasanga, Brian Latimer, Catherine L Owens, Brandon S Pruett, Yongmei Yu, Robert Luedtke, Michael J Forster, Nathalie Sumien, Donald K Ingram
The escalating increase in retirees living beyond their 8th decade brings increased prevalence of aging-related impairments, including locomotor impairment (Parkinsonism) which may affect ~50% of those reaching age 80, but has no confirmed neurobiological mechanism. Lifestyle strategies that attenuate motor decline, and its allied mechanisms, must be identified. Aging studies report little to moderate loss of striatal dopamine (DA) or tyrosine hydroxylase (TH) in nigrostriatal terminals, in contrast to ~70-80% loss associated with bradykinesia onset in Parkinson's disease...
June 20, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28637090/early-warning-systems-and-rapid-response-to-the-deteriorating-patient-in-hospital-a-realist-evaluation
#17
Jennifer Mcgaughey, Peter O'Halloran, Sam Porter, John Trinder, Bronagh Blackwood
AIM: To identify those contexts and mechanisms that enable or constrain the implementation of Rapid Response Systems on acute general hospital wards to recognise and respond to patient deterioration. BACKGROUND: Rapid Response Systems allow deteriorating patients to be recognised using Early Warning Systems, referred early via escalation protocols and managed at the bedside by competent staff. DESIGN: Realist Evaluation. METHODS: The research design was an embedded multiple case study approach of four wards in two hospitals in Northern Ireland which followed the principles of Realist Evaluation...
June 21, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28636538/phase-i-dose-escalation-study-of-the-c-met-tyrosine-kinase-inhibitor-sar125844-in-asian-patients-with-advanced-solid-tumors-including-patients-with-met-amplified-gastric-cancer
#18
Kohei Shitara, Tae Min Kim, Tomoya Yokota, Masahiro Goto, Taroh Satoh, Jin-Hee Ahn, Hyo Song Kim, Sylvie Assadourian, Corinne Gomez, Marzia Harnois, Satoshi Hamauchi, Toshihiro Kudo, Toshihido Doi, Yung-Jue Bang
SAR125844 is a potent and selective inhibitor of the c-Met kinase receptor. This was an open-label, phase I, multicenter, dose-escalation, and dose-expansion trial of SAR125844 in Asian patients with solid tumors, a subgroup of whom had gastric cancer and MET amplification (NCT01657214). SAR125844 was administered by intravenous infusion (260-570 mg/m2) on days 1, 8, 15, and 22 of each 28-day cycle. Objectives were to determine the maximum tolerated dose (MTD) and to evaluate SAR125844 safety and pharmacokinetic profile...
June 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28636456/healthcare-system-in-indonesia
#19
Suryanto, Virginia Plummer, Malcolm Boyle
The cultural diversity, its archipelago, and the major religion being Muslim have all influenced the development of the healthcare in Indonesia. The authors' objective is to describe the evolution of the healthcare system in Indonesia. Community-based health service, called puskesmas, is the key of the healthcare service in the country. The World Health Organization estimated that 64% of all deaths in Indonesia are caused by noncommunicable diseases, which might relate to the mostly unorganized prehospital care system...
June 21, 2017: Hospital Topics
https://www.readbyqxmd.com/read/28636294/-selective-therapeutic-de-escalation-in-early-stage-breast-cancer
#20
Aikaterini Liapi, Apostolos Sarivalasis, Wendy Jeanneret Sozzi, Loïc Lelièvre, Khalil Zaman
The survival of patients with breast cancer has improved considerably thanks to adjuvant radiotherapy and systemic treatments. Due to the potential adverse events associated with these treatments, a de-escalation effort was undertaken concerning surgery and more recently the adjuvant treatments. Conservative breast surgery and the avoidance of axillary dissection were possible for the majority of the patients without detrimental effect on survival. New radiotherapy techniques and the consideration of cancer biology allowed to better protect the peripheral organs and even to avoid treatment in certain low-risk patients...
May 17, 2017: Revue Médicale Suisse
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