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https://www.readbyqxmd.com/read/28226339/current-concepts-of-phenylpiperidine-derivatives-use-in-the-treatment-of-acute-and-chronic-pain
#1
Nidal Elbaridi, Alan D Kaye, Stephanie Choi, Richard D Urman
Phenylpiperidines are a chemical class of drugs with a phenyl moiety directly attached to piperidine. These agents have an important role in many aspects of medicine including anesthesia and pain medicine. After the development of meperidine, fentanyl, which is a second generation synthetic phenylpiperidine series opioid, was synthesized and introduced into clinical anesthesia practice as fentanyl citrate in 1968. Fentanyl-mediated or modulated responses involve action at the mu-opioid receptor as an agonist at the dorsal horn inhibiting ascending pain pathways in the rostral ventral medulla, increasing pain threshold, and producing both analgesic and sedative effects...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28224373/drug-induced-liver-injury-in-the-setting-of-glycogenic-hepatopathy
#2
Valmiki Maharaj, Matthew Fitz, Xianzdong Ding
Glycogenic hepatopathy (GH) is an underdiagnosed complication of uncontrolled type 1 diabetes mellitus (T1DM). It appears as an acute relapsing hepatitis with reversible transaminase elevations secondary to excessive hepatic glycogen accumulation. Patients are often asymptomatic but can present with abdominal pain, nausea and vomiting. Physical examination shows hepatomegaly without splenomegaly. GH is diagnosed by biopsy as it is clinically indistinguishable from non-alcoholic fatty liver disease (NAFLD), a more common cause of hepatic dysfunction in diabetics...
February 21, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28220461/new-generation-coronary-stents-current-data-and-future-directions
#3
REVIEW
Ankur Kalra, Hasan Rehman, Sahil Khera, Braghadheeswar Thyagarajan, Deepak L Bhatt, Neal S Kleiman, Robert W Yeh
PURPOSE OF REVIEW: Drug-eluting stents are the mainstay in the treatment of coronary artery disease using percutaneous coronary intervention. Innovations developed to overcome the limitations of prior generations of stents include biodegradable polymer stents, drug-eluting stents without a polymer, and bioabsorbable scaffolds. Our review briefly discusses the clinical profiles of first- and second-generation coronary stents, and provides an up-to-date overview of design, technology, and clinical safety and efficacy profiles of newer generation coronary stents discussing the relevant clinical trials in this rapidly evolving area of interventional cardiology...
March 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28213047/the-effect-of-combined-aspirin-and-clopidogrel-treatment-on-cancer-incidence
#4
Avi Leader, Ravit Zelikson-Saporta, David Pereg, Galia Spectre, Uri Rozovski, Pia Raanani, Doron Hermoni, Michael Lishner
BACKGROUND: Multiple studies have shown an association between aspirin treatment and a reduction in newly diagnosed cancer. Conversely, there are conflicting clinical and laboratory data regarding the effect of combined clopidogrel and aspirin therapy on cancer incidence, including analyses suggesting an increased cancer risk. No large scale cohort study has been performed to address this issue in a heterogeneous real-world scenario. We investigated the effect of clopidogrel and aspirin on cancer incidence compared to aspirin alone and no antiplatelet therapy...
February 14, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28208898/to-study-the-efficacy-of-difluprednate-ophthalmic-emulsion-and-prednisolone-acetate-ophthalmic-suspension-on-post-operative-inflammation-in-cataract-surgery
#5
Punita Garg, Nupur Tuteja, Shazia Qayum
INTRODUCTION: Senile cataract is the most common cause of visual impairment. Removal of cataract and implantation of intraocular lens implantation (IOL) is the main surgical approach for cataract. The major block in quick visual rehabilitation of the patient is post-operative inflammation. To limit post-operative inflammation corticosteroids drugs are used in routine prophylactically. Topical prednisolone acetate 1% and betamethasone 0.1% remain gold standard to control post-operative inflammation but newer drugs like difluprednate, loteprednol are also effective in controlling inflammation...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28203364/tiotropium-formulations-and-safety-a-network-meta-analysis
#6
Mario Cazzola, Luigino Calzetta, Paola Rogliani, Maria Gabriella Matera
Tiotropium is now delivered via two different inhaler devices: the original Handihaler 18 μg once daily, which uses a powder formulation; and the newer Respimat Soft Mist Inhaler (SMI) 5 μg once daily. It has been questioned whether the two devices can be assumed to have the same safety profile, although the TIOSPIR trial showed that tiotropium when administered via Respimat SMI 5 μg is not less safe than Handihaler 18 μg. Therefore, we have carried out a safety evaluation of tiotropium Handihaler 18 µg versus tiotropium Respimat SMI 5 µg and 2...
January 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28197288/serum-triglyceride-lowering-effect-of-cilnidipine-in-patients-with-essential-hypertension
#7
Prakash Kumar, Arijit Das, Satish Chandra, Manju Gari, U S P Keshri, Kusum Kumari
BACKGROUND: Many epidemiological studies have established the relationship between hypertension and dyslipidemia. Calcium channel blockers (CCBs) are one of the first-line drugs for newly diagnosed patients with essential hypertension. Cilnidipine as a newer CCB acting by blocking both L- and N-type calcium channels possesses additional beneficial effects apart from lowering blood pressure (BP). The aim of this study was to evaluate the effectiveness of cilnidipine in patients with essential hypertension with borderline dyslipidemia and its effects on lipid profile...
October 2016: Cardiology Research
https://www.readbyqxmd.com/read/28194051/consensus-in-the-management-of-multiple-myeloma-in-india-at-myeloma-state-of-the-art-2016-conference
#8
REVIEW
Uday Yanamandra, Navin Khattry, Shaji Kumar, Noopur Raje, Arihant Jain, Sundar Jagannath, Hari Menon, Lalit Kumar, Neelam Varma, Subhash Varma, Tapan Saikia, Pankaj Malhotra
The science of multiple myeloma (MM) and related plasma cell disorders is rapidly evolving with increased understanding of the disease biology and recent approval of the newer drugs widening the therapeutic armamentarium. Despite multiple international guidelines regarding the management of this disease, the practice of managing MM is not uniform amongst Indian physicians. There are challenges in management which are unique to the Indian patients. This review discusses these challenges and the consensus of the nation-wide experts in dealing with the same...
March 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28188812/epigenetics-in-cancer-fundamentals-and-beyond
#9
REVIEW
Subhankar Biswas, C Mallikarjuna Rao
Activation of oncogenes or the deactivation of tumor suppressor genes has long been established as the fundamental mechanism leading towards carcinogenesis. Although this age old axiom is vastly accurate, thorough study over the last 15years has given us unprecedented information on the involvement of epigenetic in cancer. Various biochemical pathways that are essential towards tumorigenesis are regulated by the epigenetic phenomenons like remodeling of nucleosome by histone modifications, DNA methylation and miRNA mediated targeting of various genes...
February 8, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28188122/drug-resistance-detection-and-mutation-patterns-of-multidrug-resistant-tuberculosis-strains-from-children-in-delhi
#10
Jyoti Arora, Ritu Singhal, Manpreet Bhalla, Ajoy Verma, Niti Singh, Digamber Behera, Rohit Sarin, Vithal Prasad Myneedu
A total of 312 sputum samples from pediatric patients presumptive of multidrug resistant tuberculosis were tested for the detection of drug resistance using the GenoTypeMTBDRplus assay. A total of 193 (61.8%) patients were smear positive and 119 (38.1%) were smear negative by Ziehl-Neelsen staining. A line probe assay was performed for 208 samples/cultures (193 smear positive samples and 15 cultures from smear negative samples). Valid results were obtained from 198 tests. Some 125/198 (63.1%) were sensitive to both rifampicin (RIF) and isoniazid (INH), while 73/198 (36...
February 7, 2017: Journal of Epidemiology and Global Health
https://www.readbyqxmd.com/read/28186869/sedative-hypnotic-drug-withdrawal-syndrome-recognition-and-treatment
#11
Cynthia Santos, Ruben E Olmedo
Sedative-hypnotic drugs include gamma-Aminobutyric acid (GABA)ergic agents such as benzodiazepines, barbiturates, gamma-Hydroxybutyric acid [GHB], gamma-Butyrolactone [GBL], baclofen, and ethanol. Chronic use of these substances can cause tolerance, and abrupt cessation or a reduction in the quantity of the drug can precipitate a life-threatening withdrawal syndrome. Benzodiazepines, phenobarbital, propofol, and other GABA agonists or analogues can effectively control symptoms of withdrawal from GABAergic agents...
March 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28185616/tuberculous-peritonitis
#12
Urvashi Vaid, Gregory C Kane
Tuberculous peritonitis is rare in the United States but continues to be reported to occur in certain high-risk populations, which include patients with AIDS or cirrhosis, patients on continuous ambulatory peritoneal dialysis, recent immigrants from areas of high endemicity, and those who are immunosuppressed. The diagnosis of this disease requires a high clinical index of suspicion and should be considered in the differential of ascites with a lymphocyte predominance and serum-ascitic albumin gradient of <1...
January 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28181443/new-pharmacological-approaches-in-heart-failure-therapy-developments-and-possibilities
#13
Joseph J Cuthbert, Pierpaolo Pellicori, Parin Shah, Andrew L Clark
There have been few major breakthroughs in heart failure (HF) drug therapies in recent years yet HF morbidity and mortality remain high, and there is a clear need for further research. Several newer agents that appear promising in Phase I and II trials do not progress to show clinical benefit in later trials. Part of the failure to find new therapies may lie in flawed trial design compounded by the need for ever-increasing patient numbers in order to prove outcome benefit. We summarize some of the most recent and promising medical therapies for HF...
February 9, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28177092/-newer-anti-diabetic-therapies-and-chronic-kidney-disease
#14
Luca Di Lullo, Claudio Ronco, Vincenzo Barbera, Mario Cozzolino, Francesca Santoboni, Annalisa Villani, Antonio De Pascalis, Antonio Bellasi
Worldwide, an estimated 200 million people have chronic kidney disease (CKD), whose most common causes include hypertension, arteriosclerosis, and diabetes. About 40% of patients with diabetes develop CKD. Intensive blood glucose control through pharmacological intervention can delay CKD progression. Standard therapies for the treatment of type 2 diabetes include metformin, sulfonylureas, meglitinides, thiazolidinediones and insulin. While these drugs have an important role in the management of type 2 diabetes, only the thiazolidinedione pioglitazone can be used across the spectrum of CKD (stages 25) and without dose adjustment...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28173850/new-horizons-in-treatment-of-osteoporosis
#15
REVIEW
Ozra Tabatabaei-Malazy, Pooneh Salari, Patricia Khashayar, Bagher Larijani
BACKGROUND: Prevalence of osteoporosis is increasing both in developed and developing countries. Due to rapid growth in the burden and cost of osteoporosis, worldwide, it seems reasonable to focus on the reduction of fractures as the main goal of treatment. Although, efficient pharmacological agents are available for the treatment of osteoporosis, there still remains a need to more specific drugs with less adverse effects. MAIN BODY: This review article provides a brief update on the pathogenesis, presenting current pharmacological products approved by the US Food and Drug Administration (FDA) or Europe, and also newer therapeutic agents to treat osteoporosis according to the clinical trial data available at PubMed, UpToDate, International Osteoporosis Foundation (IOF), and clinical practice guidelines...
February 7, 2017: Daru: Journal of Faculty of Pharmacy, Tehran University of Medical Sciences
https://www.readbyqxmd.com/read/28170357/on-x-valve-the-next-generation-aortic-valve
#16
Rahul Chaudhary, Jalaj Garg, Parasuram Krishnamoorthy, Neeraj Shah, Bruce A Feldman, Matthew W Martinez, Ronald Freudenberger
The On-X valve is a newer generation mechanical bileaflet valve. Its key features include the use of pure pyrolytic carbon (devoid of silicon), a length-to-diameter ratio similar to a native valve, an inlet flared orifice, a leaflet opening up to 90 degrees, a shorter leaflet closing angle, a 2-point leaflet contact, and an actuated pivot. These features have translated into increased strength, improved valve hemodynamics, reduced hemolysis, and thrombogenicity. The 2014 American Heart Association/American College of Cardiology guidelines for the management of patients with valvular heart disease recommend an international normalized ratio (INR) of 2...
March 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28169231/palbociclib-a-new-hope-in-the-treatment-of-breast-cancer
#17
REVIEW
R Priyadharsini Palanisamy
Breast cancer being one of the common cancers has high morbidity and mortality. Despite the conventional treatment, the burden of the disease increases year after year. There is a need for newer drugs that target the different mechanisms in the pathogenesis. The interaction of cyclins with cyclin dependent kinases (CDKs) plays a major role in the abnormal cell cycle in cancer and it is considered to be an important target. Palbociclib is a CDK inhibitor currently approved for the treatment of breast cancer...
October 2016: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28166912/tuberculosis-knowledge-and-attitude-in-aspiring-doctors-and-nurses-is-it-time-for-our-tb-teaching-methods-to-evolve
#18
Preetam Rajgopal Acharya, Monalisa D'Souza, Ramesh Chandra Sahoo
BACKGROUND: India accounts for nearly 24% of all the new tuberculosis (TB) cases globally. A good core knowledge and a positive outlook towards TB patients among our aspiring doctors and nurses are necessities for India to meet the Sustainable Development Goals (SDG) proposed by the WHO as a part of its post-2015 global TB strategy and to successfully combat the newer challenges posed by this disease in the future. AIMS: To evaluate knowledge related to transmission, prevention and treatment of tuberculosis amongst medical and nursing students...
January 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28163535/lesinurad-a-significant-advancement-or-just-another-addition-to-existing-therapies-of-gout
#19
REVIEW
Ajay Gupta, Pramod Kumar Sharma, Arup Kumar Misra, Surjit Singh
Gout is a metabolic disorder that usually presents as recurrent episodes of acute arthritis due to deposition of crystals in joints and cartilages. Despite the availability of several drugs for gout, its management is still less than adequate. There is always a search for newer, safer, and more potent urate-lowering therapies for treating patients inadequately controlled with available drugs. Lesinurad in combination with a xanthine oxidase inhibitor provides an effective mode of therapy in the management of hyperuricemia associated with gout...
October 2016: Journal of Pharmacology & Pharmacotherapeutics
https://www.readbyqxmd.com/read/28163500/an-analytical-study-to-correlate-serum-levels-of-levetiracetam-with-clinical-course-in-patients-with-epilepsy
#20
Varun Gupta, Kanchan Gupta, Gagandeep Singh, Sandeep Kaushal
INTRODUCTION: With the advancement of therapeutics, newer antiepileptic drugs (AEDs) like Levetiracetam (LEV), with good therapeutic efficacy and tolerability are available. But unfortunately, therapeutic drug monitoring is not routinely done in India for these drugs. OBJECTIVES: The objective of this study is to determine the range of serum levels of LEV in patients at stabilized doses and correlate them with their clinical course. MATERIALS AND METHODS: Patients with epilepsy and started on LEV were enrolled from the Neurology Department after the Ethics Committee approval...
December 2016: Journal of Neurosciences in Rural Practice
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