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https://www.readbyqxmd.com/read/28531331/diagnostic-challenges-in-meningioma
#1
Martha Nowosielski, Nobert Galldiks, Sarah Iglseder, Philipp Kickingereder, Andreas von Deimling, Martin Bendszus, Wolfgang Wick, Felix Sahm
Advances in molecular profiling and the application of advanced imaging techniques are currently refreshing diagnostic considerations in meningioma patients. Not only technical refinements but also sophisticated histopathological and molecular studies have the potential to overcome some of the challenges during meningioma management. Exact tumor delineation, assessment of tumor growth and pathophysiological parameters were recently addressed by "advanced" magnetic resonance imaging and positron emission tomography...
May 20, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/28531309/effect-of-antiretroviral-therapy-on-bone-and-renal-health-in-young-adults-infected-with-hiv-in-early-life
#2
Aylin B Unsal, Aviva S Mattingly, Sara E Jones, Julia B Purdy, James C Reynolds, Jeffrey B Kopp, Rohan Hazra, Colleen M Hadigan
Context: HIV antiretroviral (ARV) therapy is associated with renal and bone toxicity, but little is known about the potential cumulative effects in adults exposed to ARVs from birth. Objective: To prospectively evaluate renal and bone health in young adults with lifelong HIV and extensive ARV exposure. Design: Cross-sectional comparison of bone mineral density (BMD by dual-energy X-ray absorptiometry), bone turnover and renal function in young adults infected with HIV in early life (n=65) to matched healthy controls (n=23) and longitudinal evaluation (mean follow-up 4...
May 22, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28531306/association-of-long-term-opioid-therapy-with-functional-status-adverse-outcomes-and-mortality-among-patients-with-polyneuropathy
#3
E Matthew Hoffman, James C Watson, Jennifer St Sauver, Nathan P Staff, Christopher J Klein
Importance: Polyneuropathy is one of the most common painful conditions managed within general and specialty clinics. Neuropathic pain frequently leads to decisions about using long-term opioid therapy. Understanding the association of long-term opioid use with functional status, adverse outcomes, and mortality among patients with polyneuropathy could influence disease-specific decisions about opioid treatment. Objectives: To quantify the prevalence of long-term opioid use among patients with polyneuropathy and to assess the association of long-term opioid use with functional status, adverse outcomes, and mortality...
May 22, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28531289/management-of-bacteriuria-in-veterans-affairs-hospitals
#4
Emily S Spivak, Muriel Burk, Rongping Zhang, Makoto M Jones, Melinda M Neuhauser, Matthew Bidwell Goetz, Francesca E Cunningham
Background: Bacteriuria contributes to antibiotic overuse through treatment of asymptomatic bacteriuria (ASB) and long durations of therapy for symptomatic urinary tract infections (UTIs), yet large-scale evaluations of bacteriuria management among inpatients are lacking. Methods: Inpatients with bacteriuria were classified as asymptomatic or symptomatic based on established criteria applied to data collected by manual chart review. We examined frequency of treatment of ASB, factors associated with treatment of ASB, durations of therapy, and frequency of complications including Clostridium difficile infection, readmission and all-cause mortality within 28 days of discharge...
May 20, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28530525/cost-effectiveness-of-nivolumab-ipilimumab-combination-therapy-compared-with-monotherapy-for-first-line-treatment-of-metastatic-melanoma-in-the-united-states
#5
Anna Oh, Dang M Tran, Leann C McDowell, Dor Keyvani, Jay Andrew Barcelon, Oscar Merino, Leslie Wilson
BACKGROUND: The approval of new immunotherapies has dramatically changed the treatment landscape of metastatic melanoma. These survival gains come with trade-offs in side effects and costs, as well as important considerations for third-party payer systems, physicians, and patients. OBJECTIVE: To develop a Markov model to determine the cost-effectiveness of nivolumab, ipilimumab, and nivolumab-ipilimumab combination as firstline therapy in metastatic melanoma, while accounting for differential effectiveness in programmed death-ligand 1 (PD-L1) positive and negative patients...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530520/cardiovascular-disease-and-gout-real-world-experience-evaluating-patient-characteristics-treatment-patterns-and-health-care-utilization
#6
Michael H Pillinger, Sripal Bangalore, Alyssa B Klein, Scott Baumgartner, Robert Morlock
BACKGROUND: Gout, hyperuricemia, and cardiovascular disease (CVD) are prevalent conditions in the United States, and while they share common risk factors such as obesity, hypertension, hypercholesterolemia, and type 2 diabetes mellitus, relatively little is known about what patient and disease characteristics may link CVD with hyperuricemia and gout and how the presence of both diseases affects management decisions differently than for patients with gout alone. OBJECTIVE: To identify differences in patient characteristics, patterns of urate-lowering therapy (ULT) use, and gout control in gout patients with and without cardiovascular comorbidity...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28529691/recent-advances-in-predicting-responses-to-antidepressant-treatment
#7
REVIEW
Thomas Frodl
Major depressive disorder is one of the leading causes of disability in the world since depression is highly frequent and causes a strong burden. In order to reduce the duration of depressive episodes, clinicians would need to choose the most effective therapy for each individual right away. A prerequisite for this would be to have biomarkers at hand that would predict which individual would benefit from which kind of therapy (for example, pharmacotherapy or psychotherapy) or even from which kind of antidepressant class...
2017: F1000Research
https://www.readbyqxmd.com/read/28529557/a-single-center-experience-of-sorafenib-monotherapy-in-patients-with-advanced-intrahepatic-cholangiocarcinoma
#8
Ting-Ting Pan, Wei Wang, Wei-Dong Jia, Ge-Liang Xu
Patients with advanced intrahepatic cholangiocarcinoma (ICC) have a poor prognosis and the therapeutic options available for treating ICC are limited. Sorafenib, a multikinase inhibitor of vascular endothelial growth factor receptor 2 and 3, platelet derived growth factor receptor-β, B-Raf proto-oncogene, serine/threonine kinase and C-Raf proto-oncogene, serine/threonine kinase, is a novel reference standard for the treatment of advanced hepatocellular carcinoma. Sorafenib has previously been demonstrated to exhibit significant antitumor activity in various cholangiocarcinoma cell lines and in xenograft ICC models...
May 2017: Oncology Letters
https://www.readbyqxmd.com/read/28529419/comparative-study-of-efficacy-and-safety-of-botulinum-toxin-a-injections-and-subcutaneous-curettage-in-the-treatment-of-axillary-hyperhidrosis
#9
Leelavathy Budamakuntla, Eswari Loganathan, Anju George, B N Revanth, V Sankeerth, Sacchidananda Aradhya Sarvjnamurthy
BACKGROUND: Primary focal axillary hyperhidrosis is a chronic distressing disorder affecting both the sexes. When the condition is refractory to conservative management, we should go for more promising therapies like intradermal botulinum toxin A (BtxA) injections in the axilla, and surgical therapies like subcutaneous curettage of sweat glands. AIMS AND OBJECTIVES: The aim of this study is to compare the efficacy, safety and duration of action of intradermal BtxA injections in one axilla and subcutaneous curettage of sweat glands in the other axilla of the same patient with axillary hyperhidrosis...
January 2017: Journal of Cutaneous and Aesthetic Surgery
https://www.readbyqxmd.com/read/28528870/recurrent-multifocal-osteomyelitis-in-children-experience-in-a-tertiary-care-center
#10
Ana Belén Ariza Jiménez, Esmeralda Núñez Cuadros, Rocío Galindo Zavala, Leticia Núñez Caro, Gisela Díaz-Cordobés Soriano, Antonio Urda Cardona
INTRODUCTION: Chronic recurrent multifocal osteomyelitis is a rare aseptic bone inflammation that affects pediatric patients. Its management and treatment have not yet been standardized. METHODS: Retrospective, descriptive study of patients under 14 years of age diagnosed with chronic nonbacterial osteomyelitis (CNBO) in a tertiary hospital. We included patients diagnosed over the last 6 years (2010-2015) who met the Jansson criteria. The clinical and radiological characteristics of CNBO were analyzed, as was the outcome after different therapeutic options...
May 18, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28528436/the-unresolved-riddle-of-glucocorticoid-withdrawal
#11
REVIEW
F Guerrero Pérez, A P Marengo, C Villabona Artero
Glucocorticoid (GC) therapy is the most common cause of adrenal insufficiency (AI). The real prevalence of AI after GC is unknown but it could involve more than 30% of patients. Some gene variation has been associated with the variability of hypothalamic-pituitary-adrenal (HPA) axis and this issue could contribute to the individual variation of adrenal function after GC treatment. Symptoms and signs of AI are nonspecific and frequently the diagnosis is delayed. Dosage, duration of treatment, administration route and serum cortisol value are not completely useful to predict AI...
May 20, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28527874/pressor-support-during-a-jarisch-herxheimer-reaction-after-initiation-of-treatment-for-weil-s-disease
#12
Randi Connor-Schuler, Anee Khan, Nikhil Goyal, Erin Zimny
We present a case of Weil's disease complicated by a Jarisch-Herxheimer reaction (JHR) after initiation of antibiotics while in the emergency department requiring invasive monitoring and vasopressor support. The case is followed by a brief review of the JHR which is rarely observed with treatment of leptospirosis. A healthy 28-year-old female who recently returned from the Caribbean presented to the emergency department with flu-like symptoms. The patient appeared jaundiced with conjunctival suffusion and was ultimately treated with the appropriate antibiotics for leptospirosis in the ED...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28527735/advances-in-combination-therapy-of-lung-cancer-rationales-delivery-technologies-and-dosage-regimens
#13
REVIEW
Lan Wu, Donglei Leng, Dongmei Cun, Camilla Foged, Mingshi Yang
Lung cancer is a complex disease caused by a multitude of genetic and environmental factors. The progression of lung cancer involves dynamic changes in the genome and a complex network of interactions between cancer cells with multiple, distinct cell types that form tumors. Combination therapy using different pharmaceuticals has been proven highly effective due to the ability to affect multiple cellular pathways involved in the disease progression. However, the currently used drug combination designs are primarily based on empirical clinical studies, and little attention has been given to dosage regimens, i...
May 17, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28527249/-sociodemographic-and-clinical-characteristics-of-patients-infected-with-leptospira-spp-treated-at-four-hospitals-in-medell%C3%A3-n-colombia-2008-2013
#14
Lina María Echeverri-Toro, Sara Penagos, Laura Castañeda, Pablo Villa, Santiago Atehortúa, Faiver Ramírez, Carlos Restrepo, Sigifredo Ospina, Yuli Agudelo, Alicia Hidrón, Paola Agudelo, Eliana Valderrama, Carlos Andrés Agudelo
INTRODUCTION: Leptospirosis remains a significant health problem in tropical regions including Latin America, where its presentation is 100 times higher than that observed in other regions of the world. Mortality reaches 10% in severe cases. Its diagnosis is challenging because clinical manifestations during the initial phase are non-specific and because of limited availability of diagnostic tests. OBJECTIVE: To describe the demographic and clinical characteristics and the outcomes in hospitalized patients with leptospirosis...
January 24, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28527240/recurrent-deep-vein-thrombosis-after-the-first-venous-thromboembolism-event-a-single-institution-experience
#15
Mohammad Asim, Hassan Al-Thani, Ayman El-Menyar
BACKGROUND We investigated the frequency, clinical presentation, risk factors, and outcome after the first deep vein thrombosis (DVT) event. MATERIAL AND METHODS A retrospective study was conducted for patients with DVT between 2008 and 2012 with a 1-year follow-up. Patients were divided into 2 groups: single vs. recurrent DVT (RDVT). RESULTS Of the 6420 patients screened for DVT, 662 (10.3%) had DVT. RDVT constituted 22% of cases. A single event was more frequent in left lower limb DVT (p=0.01), while RDVT cases had more bilateral DVT (p=0...
May 20, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28527160/study-of-bone-mineral-density-bmd-in-patients-with-rheumatoid-arthritis-and-its-co-relation-with-severity-of-the-disease
#16
Liyakat Ali Gauri, Qadir Fatima, Sharanbasu Diggi, Asim Khan, Ambreen Liyakat, B R Ajay
INTRODUCTION: Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown etiology marked by a symmetric, peripheral polyarthritis.1-3 People with rheumatoid arthritis are at increased risk of osteoporosis. Hence this article intends to highlight the importance of BMD measurement in patients with RA as a tool for assessment of disease activity and severity. OBJECTIVE: To evaluate Bone Mineral Density in patients of Rheumatoid Arthritis and Co-relate it with severity of disease...
April 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28527061/ketogenic-diet-in-migraine-rationale-findings-and-perspectives
#17
Piero Barbanti, Luisa Fofi, Cinzia Aurilia, Gabriella Egeo, Massimiliano Caprio
Ketogenic diet (KD) is an established treatment for refractory pediatric epilepsy and a promising therapy for diverse neurological diseases. Clinical data on KD in migraine-obtained from 150 patients investigated in case reports and prospective studies-suggest that KD may be a rapid onset effective prophylaxis for episodic and chronic migraine. KD would contribute to restore brain excitability and metabolism and to counteract neuroinflammation in migraine, although its precise mechanism is still unclear. Randomized controlled studies are needed to confirm the usefulness of KD in migraine and to investigate its optimal duration, repeatability, feasibility in normal weight subjects, efficacy in pediatric population and association to conventional migraine prophylaxis...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28526978/cytogenetic-biodosimetry-and-dose-rate-effect-after-radioiodine-therapy-for-thyroid-cancer
#18
Igor K Khvostunov, Vladimir A Saenko, Valeri Krylov, Andrei Rodichev, Shunichi Yamashita
This study set out to investigate chromosomal damage in peripheral blood lymphocytes of thyroid cancer patients receiving (131)I for thyroid remnant ablation or treatment of metastatic disease. The observed chromosomal damage was further converted to the estimates of whole-body dose to project the adverse side effects. Chromosomal aberration analysis was performed in 24 patients treated for the first time or after multiple courses. Blood samples were collected before treatment and 3 or 4 days after administration of 2-4 GBq of (131)I...
May 19, 2017: Radiation and Environmental Biophysics
https://www.readbyqxmd.com/read/28526972/patient-experiences-attitudes-and-expectations-towards-receiving-information-about-anti-tnf-medication-a-quantitative-study
#19
Jon Packham, Paul Arkell, Tom Sheeran, Ann Brownfield, Anthony Cadwgan, Sarah Ryan
The objective of the study was to measure patient attitudes and experience of information received during drug counselling for rheumatoid arthritis (RA) medications. This is a cross-sectional UK postal questionnaire study. Three RA patient groups-disease-modifying antirheumatic drugs (DMARDs) only, first anti-tumour necrosis factor (anti-TNF) and failed anti-TNF-were sent postal questionnaires. Data on patient history/demographics, drug counselling experience, knowledge of drug side effects, attitudes to vaccinations, cancer screening and blood borne virus testing was collected; 264/679 (39%) patients responded (median age 65 years, 66% female, median disease duration 15 years)...
May 19, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28526905/effectiveness-of-acellular-dermal-matrix-on-autologous-split-thickness-skin-graft-in-treatment-of-deep-tissue-defect-esthetic-subjective-and-objective-evaluation
#20
Yoo Jung Lee, Myong Chul Park, Dong Ha Park, Hyung Min Hahn, Sue Min Kim, Il Jae Lee
BACKGROUND: A split-thickness skin graft (STSG) is performed to cover a large full-thickness skin defect. Esthetic and functional deficits can result, and many studies have sought to overcome them. This study compared the effectiveness of the acellular dermal matrix (ADM) graft and STSG concerning esthetic and functional effectiveness of ADM on scar quality. METHODS: Of the patients who underwent anterolateral thigh free flap from 2011 to 2015, patients who received skin graft only (n = 10) or skin graft with ADM (n = 20) for coverage of the donor site were enrolled...
May 19, 2017: Aesthetic Plastic Surgery
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