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https://www.readbyqxmd.com/read/28544274/antithrombotic-therapy-in-end-stage-renal-disease
#1
REVIEW
Svetha Chunduri, Jon E Folstad, Tushar J Vachharajani
The delicate balance of risk vs. benefit of using antiplatelet and antithrombotic agents in the general population is well established. The decision to use these agents in the end stage renal disease (ESRD) population remains complex and difficult. The concomitant association of a prothombotic state with high risk of bleeding in the ESRD population requires individualization and careful clinical judgment before implementing such therapy. There remains a paucity of clinical trials and lack of substantial evidence in literature for safe and effective use of antithrombotic drugs in patients with advanced chronic kidney disease...
May 23, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28543445/psoriasis-in-those-planning-a-family-pregnant-or-breast-feeding-the-australasian-psoriasis-collaboration
#2
REVIEW
Marius Rademaker, Karen Agnew, Megan Andrews, Katherine Armour, Chris Baker, Peter Foley, John Frew, Kurt Gebauer, Monisha Gupta, Debra Kennedy, Gillian Marshman, John Sullivan
The Australasian Psoriasis Collaboration has reviewed the evidence for managing moderate to severe psoriasis in those who are pregnant or are breast-feeding, or planning a family. The severity of the psoriasis, associated comorbidities and specific anti-psoriasis treatment, along with other exposures, can have a deleterious effect on pregnancy outcomes. Psoriasis itself increases the risk of preterm and low birthweight babies, along with spontaneous and induced abortions, but no specific birth defects have been otherwise demonstrated...
May 23, 2017: Australasian Journal of Dermatology
https://www.readbyqxmd.com/read/28542801/serum-protein-binding-of-25-antiepileptic-drugs-in-a-routine-clinical-setting-a-comparison-of-free-non-protein-bound-concentrations
#3
Philip N Patsalos, Miguel Zugman, Charlotte Lake, Anthony James, Neville Ratnaraj, Josemir W Sander
OBJECTIVE: Given that only the free non-protein-bound concentration of an antiepileptic drug (AED) crosses the blood-brain barrier, entering the brain and producing an antiepileptic effect, knowledge and measurement of the free drug fraction is important. Such data are sparse, particularly for newer AEDs, and have arisen from the use of disparate methodologies and settings over the past six decades. We report on the protein binding of 25 AEDs that are available for clinical use, along with two pharmacologically active metabolites (carbamazepine-epoxide and N-desmethyl clobazam), using standardized methodology and under set conditions...
May 24, 2017: Epilepsia
https://www.readbyqxmd.com/read/28540743/a-review-on-cardiovascular-effects-of-newer-hypoglycemic-medications
#4
B Tate Cutshall, Jennifer D Twilla, Andrew S Olinger, Carrie S Oliphant
Cardiovascular disease is the most prevalent cause of morbidity and mortality in diabetic patients. Improvement in cardiovascular complications with glycemic control and managing cardiovascular risk factors is well established. However, the impact of hypoglycemic medications on cardiovascular disease is of increasing importance. In 2008 the U.S. Food and Drug Administration issued study regulations for hypoglycemic agents after rosiglitazone was shown to increase the incidence of myocardial infarction, and the European Medicines Agency provided their own guidance in 2012...
May 25, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28535081/advances-in-antidepressants-for-treating-post-stroke-depression
#5
Stefano Paolucci
Introduction Post-stroke depression (PSD) is a common and serious complication after stroke, occurring in nearly one third of stroke survivors, and affecting mortality rate, functional outcome, rehabilitation results and quality of life. However, in the common clinical practice only a minority of patients are properly treated. A relatively small number of scientific reports are available on clinical usefulness and safety of antidepressants (ADs) in PSD. Areas Covered This report provides an updated review about pharmacological state of art of PSD, including efficacy and safety of different drugs and their role on prevention, treatment and functional outcome...
May 23, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28532663/recent-developments-in-drug-eluting-devices-with-tailored-interfacial-properties
#6
REVIEW
Eva Sanchez-Rexach, Emilio Meaurio, Jose-Ramon Sarasua
Drug eluting devices have greatly evolved during past years to become fundamental products of great marketing importance in the biomedical field. There is currently a large diversity of highly specialized devices for specific applications, making the development of these devices an exciting field of research. The replacement of the former bare metal devices by devices loaded with drugs allowed the sustained and controlled release of drugs, to achieve the desired local therapeutic concentration of drug. The newer devices have been "engineered" with surfaces containing micro- and nanoscale features in a well-controlled manner, that have shown to significantly affect cellular and subcellular function of various biological systems...
May 4, 2017: Advances in Colloid and Interface Science
https://www.readbyqxmd.com/read/28531820/adverse-effects-and-treatment-satisfaction-among-online-users-of-four-antidepressants
#7
Shannon Hughes, Jeffrey Lacasse, Reid Rogers Fuller, Jennifer Spaulding-Givens
Adverse effects (AEs) are an important factor in antidepressant treatment decision-making, though common AE profiles from clinical trial research highlight physical AEs to the neglect of emotional and behavioral AEs. First-hand accounts of antidepressant users on the Internet can supplement AE profiles with information gained from real-world treatment experiences. We examined online user reviews of two older (escitalopram; duloxetine) and two newer (vilazodone; vortioxetine) antidepressants for differences in their AE profiles and determined which categories of AEs were associated with users' satisfaction...
May 16, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28531278/cardiovascular-toxic-effects-of-targeted-cancer-therapy
#8
Kazuko Tajiri, Kazutaka Aonuma, Ikuo Sekine
Over the past decade, there has been a major shift in chemotherapy from non-specific cytotoxic drugs to molecular targeted drug therapies. As more molecular targeted therapies are developed, new types of cardiovascular toxicities induced by targeted therapies are a growing problem. Cardiotoxicity induced by the human epidermal growth factor receptor-2 inhibitor trastuzumab manifests as decreased left ventricular ejection fraction. In contrast to anthracycline treatment, most cardiac events occur during trastuzumab treatment, but are reversed quickly when treatment is interrupted and cardiac intervention is established...
May 20, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28531239/current-trends-of-hypertension-treatment-in-the-united-states
#9
Shreya J Shah, Randall S Stafford
BACKGROUND: To examine current patterns of hypertension (HTN) treatment in the United States, including blood pressure (BP) control, prevalence of different antihypertensive agents, and variations in treatment associated with patient and physician characteristics. METHODS: We used data from the National Disease and Therapeutic Index (NDTI), a nationally representative physician survey produced by QuintilesIMS. We selected patients with a diagnosis of HTN and identified those prescribed antihypertensive therapies...
May 22, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28530382/diabetes-update-new-pharmacotherapy-for-type-2-diabetes
#10
Beth Choby
Multiple new drugs for managing type 2 diabetes have entered the market in the past 5 years. Guidelines from the American Diabetes Association recommend metformin for initial therapy, followed by a second drug if A1c goals are not met or initially for patients with A1c levels greater than 9%. Conversely, the American Association of Clinical Endocrinologists recommends initial management with two drugs if the A1c level is greater than 7.5%. The risk of lactic acidosis associated with metformin has been shown to be less than previously thought, with newer guidelines permitting use with an estimated glomerular filtration rate of 45 to 60 mL/min/1...
May 2017: FP Essentials
https://www.readbyqxmd.com/read/28530033/concomitant-contraceptive-implant-and-efavirenz-use-in-women-living-with-hiv-perspectives-on-current-evidence-and-policy-implications-for-family-planning-and-hiv-treatment-guidelines
#11
REVIEW
Rena C Patel, Chelsea Morroni, Kimberly K Scarsi, Tabitha Sripipatana, James Kiarie, Craig R Cohen
INTRODUCTION: Preventing unintended pregnancies is important among all women, including those living with HIV. Increasing numbers of women, including HIV-positive women, choose progestin-containing subdermal implants, which are one of the most effective forms of contraception. However, drug-drug interactions between contraceptive hormones and efavirenz-based antiretroviral therapy (ART) may reduce implant effectiveness. We present four inter-related perspectives on this issue. DISCUSSION: First, as a case study, we discuss how limited data prompted country-level guidance against the use of implants among women concomitantly using efavirenz in South Africa and its subsequent negative effects on the use of implants in general...
May 11, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28528519/il-6-blockade-in-the-management-of-non-infectious-uveitis
#12
Giuseppe Lopalco, Claudia Fabiani, Jurgen Sota, Orso Maria Lucherini, Gian Marco Tosi, Bruno Frediani, Florenzo Iannone, Mauro Galeazzi, Rossella Franceschini, Donato Rigante, Luca Cantarini
Several pathogenetic studies have paved the way for a newer more rational therapeutic approach to non-infectious uveitis, and treatment of different forms of immune-driven uveitis has drastically evolved in recent years after the advent of biotechnological drugs. Tumor necrosis factor-α targeted therapies, the first-line recommended biologics in uveitis, have certainly led to remarkable results in patients with non-infectious uveitis. Nevertheless, the decision-making process turns out to be extremely difficult in anti-tumor necrosis factor or multidrug-resistant cases...
May 20, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28523600/sodium-channel-blockers-in-the-treatment-of-epilepsy
#13
Martin J Brodie
Sodium channel blockers have been the mainstay of the pharmacological management of focal and generalised tonic-clonic seizures for more than 70 years. The focus of this paper will be on phenytoin, carbamazepine, lamotrigine, oxcarbazepine, rufinamide, lacosamide and eslicarbazepine acetate. All these antiepileptic drugs have similar efficacy and share similar dose-dependent, adverse effect profiles, although phenytoin, carbamazepine and oxcarbazepine are more likely to cause idiosyncratic reactions than the others...
May 18, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28514806/human-epicardial-fat-expresses-glucagon-like-peptide-1-and-2-receptors-genes
#14
Gianluca Iacobellis, Vladimir Camarena, David W Sant, Gaofeng Wang
Epicardial adipose tissue (EAT) is an easily measurable visceral fat of the heart with unique anatomy, functionality, and transcriptome. EAT can serve as a therapeutic target for pharmaceutical agents targeting the fat. Glucagon-like peptide-1 (GLP-1) and GLP-2 analogues are newer drugs showing beneficial cardiovascular and metabolic effects. Whether EAT expresses GLP- 1 and 2 receptors (GLP-1R and GLP-2R) is unknown. RNA-seq analysis and quantitative real-time polymerase chain reaction (qRT-PCR) were performed to evaluate the presence of GLP-1R and GLP-2R in EAT and subcutaneous fat (SAT) obtained from 8 subjects with coronary artery disease and type 2 diabetes mellitus undergoing elective cardiac surgery...
May 17, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28511567/treating-the-chronic-phase-chronic-myeloid-leukemia-patient-which-tki-when-to-switch-and-when-to-stop
#15
Ami B Patel, Brandon W Wilds, Michael W Deininger
With the discovery of imatinib mesylate nearly 20 years ago, tyrosine kinase inhibitors (TKIs) were found to be effective in chronic myeloid leukemia (CML). TKI therapy has since revolutionized the treatment of CML and has served as a paradigm of success for targeted drug therapy in cancer. Several new TKIs for CML have been approved over the last two decades that exhibit improved potency over imatinib and have different off-target profiles, providing options for individualized therapy selection. Areas covered: Current management of chronic phase CML, including guidance on the sequential use of imatinib and newer-generation TKIs and evolving treatment strategies such as TKI discontinuation...
May 22, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28511378/cortical-potentials-prior-to-movement-in-parkinson-s-disease
#16
Ashlesh Laxman Patil, Sanjay Kumar Sood, Vinay Goyal, Kanwal Preet Kochhar
INTRODUCTION: Recording cortical potentials prior to movement (bereitschaftspotentials, BP) offer a good non invasive method for studying activity of motor related cortices in Parkinson's Disease (PD). Dopaminergic medications provide some symptomatic relief in advanced stages but they do not stop the progression of the disease. Assessing BP may be a good idea to see the response of anti PD drugs. It remains unclear whether the anti PD medications also improve cortical activity prior to movement even in advanced stages of the disease...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28510646/benefit-of-switching-dual-antiplatelet-therapy-after-acute-coronary-syndrome-the-topic-timing-of-platelet-inhibition-after-acute-coronary-syndrome-randomized-study
#17
Thomas Cuisset, Pierre Deharo, Jacques Quilici, Thomas W Johnson, Stéphanie Deffarges, Clémence Bassez, Guillaume Bonnet, Laurent Fourcade, Jean Philippe Mouret, Marc Lambert, Valentine Verdier, Pierre Emmanuel Morange, Marie Christine Alessi, Jean Louis Bonnet
Aims: Newer P2Y12 blockers (prasugrel and ticagrelor) demonstrated significant ischaemic benefit over clopidogrel after acute coronary syndrome (ACS). However, both drugs are associated with an increase in bleeding complications. The objective of the present study was to evaluate the benefit of switching dual antiplatelet therapy (DAPT) from aspirin plus a newer P2Y12 blocker to aspirin plus clopidogrel 1 month after ACS. Methods and results: We performed an open-label, monocentric, and randomized trial...
May 16, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28506521/role-of-imaging-in-response-assessment-and-individualised-treatment-for-sarcomas
#18
H Choi
The first systematic response evaluation criteria were established by WHO, based on the tumor size changes shortly after the computed tomography (CT) technique became available to the daily practice. RECIST, a simplified version of WHO criteria, and its newer version, RECIST1.1 are the currently available international response evaluation criteria in solid tumors and remains based on tumor size changes. While the introduction of molecularly targeted drugs has significantly improved the survival in patient with sarcomas, the evaluation of tumor response has become more complicated...
May 12, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28503959/emerging-drugs-for-prevention-of-t-cell-mediated-rejection-in-liver-and-kidney-transplantation
#19
Tiffany Cl Wong, Chung-Mau Lo, James Yy Fung
Acute and chronic graft rejection continues to be an important problem after solid organ transplantation. With the introduction of potent immunosuppressive agents such as calcineurin inhibitors, the risk of rejection has been significantly reduced. However, the adverse effects of life-long immunosuppression remain a concern, and there exist a fine balance between over-immunosuppression and risk of rejection. Areas covered. In this review, the current standard of care in immunosuppressive therapy, including the use of steroids, calcineurin inhibitors, mycophenolate prodrugs and mammalian target of rapamycin inhibitors, will be discussed...
May 15, 2017: Expert Opinion on Emerging Drugs
https://www.readbyqxmd.com/read/28503886/life-threatening-drug-interactions-what-the-physician-needs-to-know
#20
Richard O Day, Leone Snowden, Andrew J McLachlan
Adverse drug-drug interactions are a significant cause of adverse events and outcomes. Their incidence is rising, with more patients taking more drugs, and newer, more precise but often more hazardous drugs becoming available. Despite considerable information, including computerised alerts about potential adverse drug-drug interactions, prescribers increasingly override alerts, possibly symptomatic of the immense problem of evaluating the risk of an interaction in a particular patient. Many reports emanate from small studies often of normal and young volunteers, entirely different from the real world where, more often, older patients with multiple health conditions are receiving many more than the two drugs identified in the drug interaction report...
May 2017: Internal Medicine Journal
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