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Ramesh Kumar, Frederic W B Deleyiannis, Corbett Wilkinson, Brent R O'Neill
OBJECTIVE The authors' goals in this study were to describe a series of dog attacks on children that required neurosurgical consultation and to better understand the pattern of injuries inflicted, the circumstances that place children at risk for attack, and the dog breeds involved. In addition, the authors review the surgical and medical management of these patients. METHODS The authors performed a retrospective review of all children requiring neurosurgical consultation for dog bite at a regional Level 1 pediatric trauma center over a 15-year period...
October 21, 2016: Journal of Neurosurgery. Pediatrics
Dora M Gorman, Carel W le Roux, Neil G Docherty
Bariatric surgery, initially intended as a weight-loss procedure, is superior to standard lifestyle intervention and pharmacological therapy for type 2 diabetes in obese individuals. Intensive medical management of hyperglycemia is associated with improved microvascular outcomes. Whether or not the reduction in hyperglycemia observed after bariatric surgery translates to improved microvascular outcomes is yet to be determined. There is substantial heterogeneity in the data relating to the impact of bariatric surgery on diabetic retinopathy (DR), the most common microvascular complication of diabetes...
October 2016: Diabetes & Metabolism Journal
Ayse Ruveyda Ugur, Hatice Turk Dagi, Bahadir Ozturk, Gulsum Tekin, Duygu Findik
BACKGROUND: Methicillin resistance is a serious health concern since it has spread among Staphylococcus aureus and coagulase-negative Staphylococci (CoNS) that are frequent community and nosocomial pathogens worldwide. Methicillin-resistant strains are often resistant to other classes of antibiotics, making their treatment difficult. Nigella sativa oil is known to be active against Gram-positive cocci, yet its in vitro cytotoxicity is rarely investigated, is a proper and powerful candidate for treatment of methicillin-resistant isolates...
July 2016: Pharmacognosy Magazine
Brit Long, Alex Koyfman
BACKGROUND: Ventricular tachycardia (VT) and ventricular fibrillation are the causes of approximately 300,000 deaths per year in the United States. VT is classified based on hemodynamic status and appearance. Stable, monomorphic VT treatment is controversial. OBJECTIVE: Our aim was to provide emergency physicians with an evidence-based review of the medical management of stable, monomorphic VT. DISCUSSION: Stable, monomorphic VT is part of a larger class of ventricular dysrhythmias defined by a rate of at least 120 beats/min with QRS > 120 ms without regularly occurring P:QRS association...
October 14, 2016: Journal of Emergency Medicine
Brittany L Bychkovsky, Don S Dizon, William M Sikov
Breast cancer is a heterogenous disease, comprised of at least 3 major subtypes: hormone receptor-positive/HER2-(HR+), HER2+, and HR-/HER2-(triple negative) breast cancers. The medical management of each subype is distinct. In this article, we review contemporary data supporting the use of chemotherapy, endocrine therapy and biologic therapies, especially HER2-directed agents, in the adjuvant and neoadjuvant setting in patients with newly diagnosed nonmetastatic (stage I-III) breast cancer.
October 12, 2016: Clinical Obstetrics and Gynecology
Vikrant Mahajani, Vidya Suratkal
Takotsubo Cardiomyopathy (TC) is also known as Stress Induced Cardiomyopathy or Broken Heart Syndrome. Typically there is transient systolic dysfunction of the apical or the mid segments of the left ventricle that occurs in the presence of acute emotional stress. Some atypical variants have been described. Hyperadrenergic state associated with emotional stress is cited as the probable etiology. It mimics Acute Myocardial Infarction with concomitant rise in cardiac biomarkers, ECG, 2D-Echocardiography abnormalities comprising of left ventricular dysfunction with regional wall motion abnormality, no significant Coronary Artery Disease on angiography...
June 2016: Journal of the Association of Physicians of India
V Pompa, P Papi, M Coletti, L Bresadola
OBJECTIVE: Acute aortic dissection (AAD) is one of the most frequent aortic emergencies, which occurs to the vascular specialist. Endovascular reconstruction of the true lumen using minimally invasive stent grafting or stenting has become increasingly popular and widespread among institutions. The aim of this paper is to report a case series composed by twenty-eight patients, who underwent endovascular intervention for acute type B aortic dissections complicated by rupture using thoracic endovascular aortic repair (TEVAR)...
September 2016: European Review for Medical and Pharmacological Sciences
J V Turner, S Agatonovic-Kustrn, Hrg Ward
Clinical use of drugs is approved for specified clinical indication, route of administration, dose and population group. Off-label prescribing of a registered medicine occurs outside of these parameters and may be justified by pharmacology and physiology, as well as sufficient evidence from published clinical trials and reviews. Misoprostol and mifepristone in combination have recently been registered in Australia for medical termination of pregnancy in women of child-bearing age. There is good clinical evidence for efficacy and safety of misoprostol in uterine evacuation in both miscarriage and termination of pregnancy...
December 28, 2015: Facts, Views & Vision in ObGyn
Ian R Logan, Urszula L McClurg, Dominic L Jones, Daniel J O'Neill, Fadhel S Shaheen, John Lunec, Luke Gaughan, Craig N Robson
Inhibition of androgen receptor (AR) signalling represents the conventional medical management of prostate cancer. Ultimately this treatment fails because tumors develop an incurable, castrate resistant phenotype, resulting in an unmet need for new treatments in prostate cancer. The AR remains a viable therapeutic target in castrate resistant disease, such that novel ways of downregulating AR activities are attractive as potential treatments. Here we describe a mechanism by which the AR can be downregulated by the MDM2 antagonist Nutlin-3, resulting in loss of pro-survival c-FLIP gene expression and apoptosis...
October 9, 2016: Oncotarget
Alexandre Minetto Brabo, Nayrana Soares Do Carmo Reis, Pasqual Barretti, Daniela Ponce
Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis that carries a high morbidity and mortality. Although its pathogenesis is still not clear, the "two hit theory" suggests that long term deterioration of the peritoneum combined with intraperitoneal inflammation is needed in the pathogenesis of EPS. To date, there is no proven effective therapy with an absence of randomized controlled trials. Individual case reports and small case series have reported on the use of tamoxifen and corticosteroids for medical management of EPS...
October 9, 2016: Hemodialysis International
Partha Pratim Bose, Prakash Kumar
Visceral leishmaniasis is a neglected tropical disease and may prove fatal if not diagnosed and treated early. The amastigotes of Leishmania donovani nest in the macrophage of human host and thus, determination of parasitic burden in the infected macrophages has been the most crucial step in diagnosis, dose determination and medical management of relapse cases of this fatal disease. Microscopic count following Giemsa staining and other morphological analysis are the classical ways vastly used in the resource stringent endemic areas...
October 5, 2016: Biochemical and Biophysical Research Communications
E Martinelli, C Locatelli, S Bassis, S Crosara, S Paltrinieri, P Scarpa, I Spalla, A M Zanaboni, C Quintavalla, P Brambilla
BACKGROUND: Veterinary literature lacks data about cardiovascular-renal disorders (CvRD) and cardiorenal-anemia syndrome (CRAS) in dogs. HYPOTHESIS: A direct correlation exists between ACVIM class and IRIS stage; chronic kidney disease (CKD) complicates chronic mitral valve disease (CMVD) more often than does anemia in dogs. ANIMALS: One hundred and fifty-eight client-owned dogs with CMVD. METHODS: Signalment, physical examination findings, electrocardiography, thoracic radiographs, echocardiography, and blood analysis were retrospectively evaluated to assess the prevalence of CKD and anemia in dogs with CMVD and to investigate the relationships among ACVIM class, IRIS stage, and survival...
September 2016: Journal of Veterinary Internal Medicine
Greg T Bishop, Jeffery R Zuba, Allan P Pessier, Jane Hopper, Gloria Kendall, Rod A W Rosychuk, K Gary Magdesian
Recurrent eosinophilic granuloma (EG) in two captive eastern black rhinoceros ( Diceros bicornis michaeli) was effectively managed with glucocorticoids and antihistamines. The first case was a female and the second case was a male. The animals were housed at separate institutions and initially presented with hemorrhagic oral lesions. Multifocal lesions occurred in the second case. Multiple biopsies were taken from each animal, all of which were consistent with EG. Each animal was anesthetized multiple times for surgical treatment but experienced frequent recurrence...
September 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Alexa J McDermott, Cara L Field, Lisa A Hoopes, Tonya M Clauss
An adult, female, reef manta ray (Manta alfredi) was evaluated for abnormal swimming and coelomic distention after colliding with a floating dock in an exhibit. Initial clinical signs included abnormal posture and swimming. Clinical signs progressed to include muscle wasting, poor body condition, and coelomic distention. Further diagnostics revealed excessive exhibit substrate within the gastrointestinal tract, gastric ulcers, free coelomic fluid, possible spinal lesion, possible uterine abnormality, and hematologic changes...
September 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Joel Narveson, Matthew D Haberl, Patrick J Grabowski
Study Design Case report. Background Intra-articular hip pathologies can be difficult to diagnose, and evidence to guide physical therapy interventions is lacking. The purpose of this report is to describe a clinical pathway for conservative management of a patient with an acute acetabular labral tear (ALT) and femoroacetabular impingement (FAI). Case Description The patient was an 18-year-old woman with recent onset of right groin pain who underwent intra-articular corticosteroid injection and therapeutic exercise for the management of an acute ALT identified on radiographic imaging...
September 29, 2016: Journal of Orthopaedic and Sports Physical Therapy
Menglong Zhou, Guichao Li, Zhen Zhang
Gastric cancer(GC) is a highly heterogeneous malignancy. The present widely used histopathological classifications have gradually failed to meet the needs of individualized diagnosis and treatment. Development of technologies such as microarray and next-generation sequencing (NGS) has allowed GC to be studied at the molecular level. Mechanisms about tumorigenesis and progression of GC can be elucidated in the aspects of gene mutations, chromosomal alterations, transcriptional and epigenetic changes, on the basis of which GC can be divided into several subtypes...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Alfonso Fasano, Silke Appel-Cresswell, Mandar Jog, Mateusz Zurowkski, Sarah Duff-Canning, Melanie Cohn, Marina Picillo, Christopher R Honey, Michel Panisset, Renato Puppi Munhoz
In this review, we have gathered all the available evidence to guide medication management after deep brain stimulation (DBS) in Parkinson's disease (PD). Surprisingly, we found that almost no study addressed drug-based management in the postoperative period. Dopaminergic medications are usually reduced, but whether the levodopa or dopamine agonist is to be reduced is left to the personal preference of the treating physician. We have summarized the pros and cons of both approaches. No study on the management of cognitive problems after DBS has been done, and only a few studies have explored the pharmacological management of such DBS-resistant symptoms as voice (amantadine), balance (donepezil) or gait disorders (amantadine, methylphenidate)...
September 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Paolo Gionchetti, Axel Dignass, Silvio Danese, Fernando José Magro Dias, Gerhard Rogler, Péter Laszlo Lakatos, Michel Adamina, Sandro Ardizzone, Christianne J Buskens, Shaji Sebastian, Silvio Laureti, Gianluca M Sampietro, Boris Vucelic, C Janneke van der Woude, Manuel Barreiro-de Acosta, Christian Maaser, Francisco Portela, Stephan R Vavricka, Fernando Gomollón
This paper is the second in a series of two publications relating to the European Crohn's and Colitis Organisation (ECCO) evidence based consensus on the diagnosis and management of Crohn's disease and concerns the surgical management of Crohn's disease as well as special situations including management of perianal Crohn's disease and extraintestinal manifestations. Diagnostic approaches and medical management of Crohn's disease of this ECCO Consensus are covered in the first paper [Gomollon F et al JCC 2016]...
September 22, 2016: Journal of Crohn's & Colitis
Fernando Gomollón, Axel Dignass, Vito Annese, Herbert Tilg, Gert Van Assche, James O Lindsay, Laurent Peyrin-Biroulet, Garret J Cullen, Marco Daperno, Torsten Kucharzik, Florian Rieder, Sven Almer, Alessandro Armuzzi, Marcus Harbord, Jost Langhorst, Miquel Sans, Yehuda Chowers, Gionata Fiorino, Pascal Juillerat, Gerassimos J Mantzaris, Fernando Rizzello, Stephan Vavricka, Paolo Gionchetti
This paper is the first in a series of two publications relating to the European Crohn's and Colitis Organisation (ECCO) evidence based consensus on the diagnosis and management of Crohn's disease and concerns the methodology of the consensus process, classification, diagnosis and medical management of active and quiescent Crohn's disease. Surgical management as well as special situations including management of perianal Crohn's disease of this ECCO Consensus are covered in a subsequent second paper [Gionchetti et al JCC 2016]...
September 22, 2016: Journal of Crohn's & Colitis
Sanath Krishna Muliya, Mudraje Narayana Bhat
AIM: To study the hematology and serum biochemistry parameters of Indian spectacled cobra (Naja naja) and Indian rat snake (Ptyas mucosa) and to evaluate the differences in the same between captive and wild populations. MATERIALS AND METHODS: Animals were categorized into four groups, viz., wild Indian spectacled cobra (n=10), wild Indian rat snakes (n=10), captive Indian spectacled cobra (n=10), and captive Indian rat snake (n=10). The snakes were restrained with restraint tubes, and 2 ml of blood was collected from either heart or ventral coccygeal vein...
August 2016: Veterinary World
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