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acid-base disorders guidelines

Lisa M Christian, Andrea S Young, Amanda M Mitchell, Martha A Belury, Barbara L Gracious, L Eugene Arnold, Mary A Fristad
Guidelines for suggested intake of ω-3 polyunsaturated fatty acids (PUFAs) are limited in youth and rely primarily on age. However, body weight varies considerably within age classifications. The current analyses examined effects of body weight and body mass index (BMI) on fatty acid accumulation in 64 youth (7-14 years) with a diagnosed mood disorder in a double-blind randomized-controlled trial (2000mg ω-3 supplements or a control capsule) across 12 weeks. Weight and height were measured at the first study visit and EPA and DHA levels were determined using fasting blood samples obtained at both the first and end-of-study visits...
2017: PloS One
Sankar Basu, Fredrik Söderquist, Björn Wallner
The focus of the computational structural biology community has taken a dramatic shift over the past one-and-a-half decades from the classical protein structure prediction problem to the possible understanding of intrinsically disordered proteins (IDP) or proteins containing regions of disorder (IDPR). The current interest lies in the unraveling of a disorder-to-order transitioning code embedded in the amino acid sequences of IDPs/IDPRs. Disordered proteins are characterized by an enormous amount of structural plasticity which makes them promiscuous in binding to different partners, multi-functional in cellular activity and atypical in folding energy landscapes resembling partially folded molten globules...
April 1, 2017: Journal of Computer-aided Molecular Design
Colin Watterson, Nicholas Beacher
Data sourcesCochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register, a regularly updated database informed by trials identified within electronic databases including MEDLINE. Further defined searches were undertaken in PubMed, Embase, The Cochrane Library, and WHO International Clinical Trials Registry Platform. Additional hand searching of relevant journals and books of conference proceedings was undertaken.Study selectionRandomised and quasi-randomised controlled trials in people of all ages with haemophilia or VWD undergoing oral or dental procedures using antifibrinolytic agents (tranexamic acid (TXA) or epsilon aminocaproic acid (EACA)) to prevent perioperative bleeding compared to no intervention with or without placebo...
March 2017: Evidence-based Dentistry
Till Weidner, Tanja Illing, Diana Miguel, Peter Elsner
BACKGROUND: Porokeratosis (PK) is a rare skin disease of unknown etiology. It consists of a keratinization disorder, which may appear in several clinical forms and can undergo malignant transformation. The histopathological hallmark of PK is the cornoid lamella. While many topical, systemic, and surgical treatment modalities for PK have been described, no randomized controlled trials have been performed yet. Because of a lack of treatment standards for PK, European and international guidelines cannot be created...
March 10, 2017: American Journal of Clinical Dermatology
Yasmine C Probst, Vivienne X Guan, Katherine Kent
INTRODUCTION: Dietary phytochemicals are found in plant-based foods such as fruits, vegetables and grains and may be categorised in a nested hierarchical manner with many hundred individual phytochemicals identified to date. To associate phytochemical intakes with positive health outcomes, a fundamental step is to accurately estimate the dietary phytochemical intake from foods reported. The purpose of this systematic review protocol is to describe the process to be undertaken to summarise the evidence for food-based dietary phytochemical intakes and health outcomes for adults...
February 15, 2017: BMJ Open
Bader Hamza Shirah, Hamza Asaad Shirah
BACKGROUND: Hidradenitis suppurativa is a chronic inflammatory cutaneous disorder that involves the infundibular terminal follicles in areas rich in apocrine glands and associated with the formation of abscesses and fistulating sinus. The clinical course is variable, and definitive evidence-based guidelines for the management are not well-established. Conservative treatment is controversial, and surgical excision is the recommended method. Herein, we aim to analyze the results of a modified conservative tissue preserving management protocol for stage I axillary hidradenitis suppurativa...
December 16, 2016: Journal of Dermatological Treatment
Carlos Torrente Artero
Metabolic acid-base disorders are common in emergency and critically ill patients. Clinicians may have difficulty recognizing their presence when multiple acid-base derangements are present in a single patient simultaneously. The anion gap and the strong ion gap concepts are useful calculations to identify the components of complex metabolic acid-base associated to the presence of unmeasured anions. This article presents their definition, normal values, indications, limitations, and guidelines for interpretation of changes in the clinical setting...
March 2017: Veterinary Clinics of North America. Small Animal Practice
John M Weiler, John D Brannan, Christopher C Randolph, Teal S Hallstrand, Jonathan Parsons, William Silvers, William Storms, Joanna Zeiger, David I Bernstein, Joann Blessing-Moore, Matthew Greenhawt, David Khan, David Lang, Richard A Nicklas, John Oppenheimer, Jay M Portnoy, Diane E Schuller, Stephen A Tilles, Dana Wallace
The first practice parameter on exercise-induced bronchoconstriction (EIB) was published in 2010. This updated practice parameter was prepared 5 years later. In the ensuing years, there has been increased understanding of the pathogenesis of EIB and improved diagnosis of this disorder by using objective testing. At the time of this publication, observations included the following: dry powder mannitol for inhalation as a bronchial provocation test is FDA approved however not currently available in the United States; if baseline pulmonary function test results are normal to near normal (before and after bronchodilator) in a person with suspected EIB, then further testing should be performed by using standardized exercise challenge or eucapnic voluntary hyperpnea (EVH); and the efficacy of nonpharmaceutical interventions (omega-3 fatty acids) has been challenged...
September 15, 2016: Journal of Allergy and Clinical Immunology
Mary A Fristad
Treatment guidelines recommend that psychotherapy be used in conjunction with pharmacotherapy in children with bipolar disorder. A well-established category of psychotherapy is family skill-building plus psychoeducation; 3 examples of this are family-focused treatment, psychoeducational psychotherapy, and child- and family-focused cognitive-behavioral therapy. These treatments share several common elements that are important in pediatric populations, including being family-based, providing psychoeducation on symptoms and their management, and training patients and families in emotion regulation, communication, and problem-solving skills...
2016: Journal of Clinical Psychiatry
Masamitsu Morishita, Nanae Matsuo, Yukio Maruyama, Masatsugu Nakao, Izumi Yamamoto, Yudo Tanno, Ichiro Ohkido, Masato Ikeda, Keitaro Yokoyama, Takashi Yokoo
BACKGROUND: Several guidelines have set the target levels of serum Ca, phosphorus, and parathyroid hormone (PTH) for better management of chronic kidney disease-mineral and bone disorders (CKDMBD) in dialysis patients. Although serum ionized Ca (iCa) is a biologically active component, corrected Ca (cCa) is used in clinical settings. However, the association between iCa and cCa is affected by acid-base status. We investigated the difference in acid-base and the calcium-parathyroid status between hemodialysis (HD) and peritoneal dialysis (PD)...
August 2016: Clinical Nephrology
Michael Vincent, Mark Whidden, Santiago Schnell
Intrinsically disordered proteins fail to adopt a stable three-dimensional structure under physiological conditions. It is now understood that many disordered proteins are not dysfunctional, but instead engage in numerous cellular processes, including signaling and regulation. Disorder characterization from amino acid sequence relies on computational disorder prediction algorithms. While numerous large-scale investigations of disorder have been performed using these algorithms, and have offered valuable insight regarding the prevalence of protein disorder in many organisms, critical proteome-based descriptive statistical guidelines that would enable the objective assessment of intrinsic disorder in a protein of interest remain to be established...
June 2016: Biophysical Chemistry
Mark Tarnopolsky, Hans Katzberg, Basil J Petrof, Sandra Sirrs, Harvey B Sarnat, Kimberley Myers, Nicolas Dupré, Dubravka Dodig, Angela Genge, Shannon L Venance, Lawrence Korngut, Julian Raiman, Aneal Khan
Pompe disease is a lysosomal storage disorder caused by a deficiency of the enzyme acid alpha-glucosidase. Patients have skeletal muscle and respiratory weakness with or without cardiomyopathy. The objective of our review was to systematically evaluate the quality of evidence from the literature to formulate evidence-based guidelines for the diagnosis and management of patients with Pompe disease. The literature review was conducted using published literature, clinical trials, cohort studies and systematic reviews...
July 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Philip S Mehler, Kristine Walsh
OBJECTIVE: Eating disorders that are associated with purging behaviors are complicated by frequent blood electrolyte and acid-base abnormalities. Herein, we review the major electrolyte and acid-base abnormalities and their treatment methods. The body of rigorous, eating disorder-specific literature on this topical area is not robust enough to perform a systematic review as defined by PRISMA guidelines. Therefore, a qualitative review of mostly medical literature was conducted. RESULTS: Hypokalemia, hyponatremia, and sodium chloride-responsive metabolic alkalosis are the most common serum changes that occur as a result of purging behaviors...
March 2016: International Journal of Eating Disorders
Ossama Abbas, Alfred Ammoury, Mohammad Abbadi, Medhat Abdel Malek, Laith Akkash, Kamal Al-Chakharah, Khalil Al-Hamdi, Firas Al-Qarqaz, Abduljabbar Al-Soudani, Nameer Al-Soudani, Anwar Dandashle, Fouad El-Sayed, Yasser Ghafir, Nazek Gargour, Said Kabalan, Abdul-Ghani Kibbi, Isam Oumeish, Zeina Tannous, Roland Tomb
Psoriasis vulgaris is a common chronic, inflammatory, multisystem disorder that affects approximately 1.5% to 3.4% of the population in the Middle East. The disease has an impact on the quality of life in a significant number of affected patients. The majority of patients (approximately 70%) have mild to moderate psoriasis that is manageable with topical agents, which generally show a high efficacy to safety ratio. Topical agents can be used alone when treating patients with limited disease or may be used as adjunctive therapy for patients with more extensive psoriasis undergoing systemic treatment...
2015: Skinmed
Amir Qaseem, Michael J Barry, Devan Kansagara
DESCRIPTION: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the comparative effectiveness of treatment with second-generation antidepressants versus nonpharmacologic treatments for major depressive disorder in adults. METHODS: This guideline is based on a systematic review of published, English-language, randomized, controlled trials from 1990 through September 2015 identified using several databases and through hand searches of references of relevant studies...
March 1, 2016: Annals of Internal Medicine
Sébastien Lévesque, Christiane Auray-Blais, Elaine Gravel, Michel Boutin, Laura Dempsey-Nunez, Pierre-Etienne Jacques, Sébastien Chenier, Sandrine Larue, Marie-France Rioux, Walla Al-Hertani, Amelie Nadeau, Jean Mathieu, Bruno Maranda, Valérie Désilets, Paula J Waters, Joan Keutzer, Stephanie Austin, Priya Kishnani
BACKGROUND: Late-onset Pompe disease (LOPD) is a rare treatable lysosomal storage disorder characterized by progressive lysosomal glycogen accumulation and muscle weakness, with often a limb-girdle pattern. Despite published guidelines, testing for LOPD is often overlooked or delayed in adults, owing to its low frequency compared to other muscle disorders with similar muscle patterns. Next-generation sequencing has the capability to test concurrently for several muscle disorders. This could potentially lead to increased diagnosis of LOPD, disorders with non-specific muscle weakness or atypical patients...
2016: Orphanet Journal of Rare Diseases
Todd J Swick
Cataplexy is defined as episodes of sudden loss of voluntary muscle tone triggered by emotions generally lasting <2 minutes. Cataplexy is most commonly associated with and considered pathognomonic for narcolepsy, a sleep disorder affecting ~0.05% of the general population. Knowledge of the pathophysiology of cataplexy has advanced through study of canine, murine, and human models. It is now generally considered that loss of signaling by hypothalamic hypocretin/orexin-producing neurons plays a key role in the development of cataplexy...
2015: Nature and Science of Sleep
Peter G Gibson, Anne E Vertigan
Chronic refractory cough (CRC) is defined as a cough that persists despite guideline based treatment. It is seen in 20-46% of patients presenting to specialist cough clinics and it has a substantial impact on quality of life and healthcare utilization. Several terms have been used to describe this condition, including the recently introduced term cough hypersensitivity syndrome. Key symptoms include a dry irritated cough localized around the laryngeal region. Symptoms are not restricted to cough and can include globus, dyspnea, and dysphonia...
December 14, 2015: BMJ: British Medical Journal
Andreas E Kremer, Barbara Namer, Ruth Bolier, Michael J Fischer, Ronald P Oude Elferink, Ulrich Beuers
Pruritus is a preeminent symptom in patients with chronic cholestatic liver disorders such as primary biliary cirrhosis and primary sclerosing cholangitis. More than two-thirds of these patients experience itching during the course of their disease. This symptom is also frequently observed in patients with other causes of cholestasis such as cholangiocarcinoma, inherited forms of cholestasis and intrahepatic cholestasis of pregnancy, but may accompany almost any other liver disease. The pathogenesis of pruritus of cholestasis remains largely elusive...
2015: Digestive Diseases
U Bonnet, A Ossowski, M Schubert, H Gall, I Steinkamp, L E Richter, Y Khalil-Boutros, A Nefedev, R Kuhlmann
We present the case of a 76 year old female inpatient who suffered from a chronic intractable cough which arose simultaneously to a severe major depression and was secondary to an exorbitant psychological distress. Chronic cough had never been experienced before and was initially considered to have a mere psychogenic origin since a comprehensive and guideline-based diagnostic screening did not reveal any underlying somatic cause. However, several factors cast doubt on the solitary psychic genesis of the chronic cough: i) occurrence immediately after a penetrant cold, ii) embedding in other complaints of laryngeal hyperreagibility (larynx irritable), such as persistent globus pharyngeus sensation, throat clearing and episodic dysphonia, iii) first occurrence on old life, iv) erupting from sleep as well, v) persistence despite remission of the major depression, and v) no sustaining benefit from specific psychotherapy and speech therapy...
October 2015: Fortschritte der Neurologie-Psychiatrie
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