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https://www.readbyqxmd.com/read/28920012/comparative-effectiveness-for-glycemic-control-in-older-adults-with-diabetes
#1
Michael Quartuccio, Brian Buta, Rita R Kalyani
PURPOSE OF REVIEW: To review and summarize the current data for comparative effectiveness of glycemic control in older adults. RECENT FINDINGS: In the last several years, professional societies have released guidelines for glycemic control in older adults, generally recommending individualized HbA1c goals. However, recent observational studies demonstrate that many older adults remain aggressively managed and are at increased risk of hypoglycemia. Large randomized trials of older adults with diabetes have failed to show cardiovascular benefit from intensive glycemic control and show only minimal microvascular benefit...
September 2017: Current Geriatrics Reports
https://www.readbyqxmd.com/read/28919008/immunoadsorption-in-neurological-disorders
#2
REVIEW
Satoru Oji, Kyoichi Nomura
In recent years, immunoadsorption has been increasingly recognized as an alternative to therapeutic plasma exchange and used for the treatment of neurological disorders such as Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, myasthenia gravis, neuromyelitis optica spectrum disorders, and multiple sclerosis, as well as autoimmune encephalitis. Unlike therapeutic plasma exchange, which requires fluid replacement with a blood solution such as fresh frozen plasma or albumin, immunoadsorption is a blood purification technique that enables the selective removal of humoral factors from separated plasma through a high-affinity adsorbent with tryptophan or phenylalanine...
August 26, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28917389/alternative-treatment-strategies-for-catatonia-a-systematic-review
#3
REVIEW
Scott R Beach, Federico Gomez-Bernal, Jeff C Huffman, Gregory L Fricchione
BACKGROUND: Catatonia is a commonly encountered syndrome, affecting 10-20% of various psychiatric populations and carrying significant medical co-morbidities. However, there are few established alternative treatment strategies when benzodiazepines are ineffective and electroconvulsive therapy is unavailable. OBJECTIVE: The authors systematically review evidence for alternative treatment strategies for catatonia using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines...
September 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28916931/physical-exercise-prescription-in-metabolic-chronic-disease
#4
Laura Stefani, Giorgio Galanti
Metabolic syndrome as a consequence of the association to overweight, hypertension, and diabetes is at high risk of coronary events. Regular physical training has been recently promoted to reduce cardiovascular risks factors, by the improved lifestyle and also by the "anti-inflammatory effectiveness." A positive impact has been shown in case of cancer survived patients either with or without comorbidities and especially in those subjects where the inflammatory process is globally represented. The American College of Sports Medicine (ACSM) guidelines and more recently a new Italian model both support the role of "exercise as therapy" at moderate level of energy expenditure...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28916863/intracerebral-hemorrhage-as-a-manifestation-of-cerebral-hyperperfusion-syndrome-after-carotid-revascularization-systematic-review-and-meta-analysis
#5
REVIEW
Pedro Abreu, Jerina Nogueira, Filipe Brogueira Rodrigues, Ana Nascimento, Mariana Carvalho, Ana Marreiros, Hipólito Nzwalo
BACKGROUND: Intracerebral hemorrhage (ICH) in the context of cerebral hyperperfusion syndrome (CHS) is an uncommon but potentially lethal complication after carotid revascularization for carotid occlusive disease. Information about its incidence, risk factors and fatality is scarce. Therefore, we aimed to perform a systematic review and meta-analysis focusing on the incidence, risk factors and outcomes of ICH in the context of CHS after carotid revascularization. METHODS: We searched the PubMed and EBSCO hosts for all studies published in English about CHS in the context of carotid revascularization...
September 15, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28915960/pleiotropic-effects-of-metformin-to-rescue-statin-induced-muscle-injury-and-insulin-resistance-a-proposed-mechanism-and-potential-clinical-implications
#6
Nicholas W Carris, Srinivas M Tipparaju, David J Magness, Kalyan C Chapalamadugu, Ronald R Magness
The 2013 American Heart Association Blood Cholesterol Guidelines increased the number of patients recommended for statin therapy in the United States to 56million. Two common statin side effects are muscle pain, referred to as "statin-associated muscle symptoms", and increased risk for new onset type-2-diabetes mellitus. Up to 25% of statin users report muscle symptoms resulting in many patients being switched to lower dose or lower potency statins, or refusing statins altogether. The most likely signaling mechanisms for statin-associated muscle symptoms overlaps with the proposed mechanism of statin-induced insulin resistance...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28915908/advances-in-paediatrics-in-2016-current-practices-and-challenges-in-allergy-autoimmune-diseases-cardiology-endocrinology-gastroenterology-infectious-diseases-neonatology-nephrology-neurology-nutrition-pulmonology
#7
REVIEW
Carlo Caffarelli, Francesca Santamaria, Dora Di Mauro, Carla Mastrorilli, Silvia Montella, Sergio Bernasconi
This review reports main progresses in various pediatric issues published in Italian Journal of Pediatrics and in international journals in 2016. New insights in clinical features or complications of several disorders may be useful for our better understanding. They comprise severe asthma, changing features of lupus erythematosus from birth to adolescence, celiac disease, functional gastrointestinal disorders, Moebius syndrome, recurrent pneumonia. Risk factors for congenital heart defects, Kawasaki disease have been widely investigated...
September 16, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28914546/defibrotide-an-oligonucleotide-for-sinusoidal-obstruction-syndrome
#8
May T Aziz, Payal P Kakadiya, Samantha M Kush, Kylie Weigel, Denise K Lowe
OBJECTIVE: To review the efficacy and safety of defibrotide as well as its pharmacology, mechanism of action, pharmacokinetics (PK), drug-drug interactions, dosing, cost considerations, and place in therapy. DATA SOURCES: A PubMed search was performed through August 2017 using the terms defibrotide, oligonucleotide, hepatic veno-occlusive disease (VOD), sinusoidal obstruction syndrome (SOS), and hematopoietic cell transplantation (HCT). Other data sources were from references of identified studies, review articles, and conference abstracts plus manufacturer product labeling and website, the Food and Drug Administration website, and clinicaltrials...
September 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28914199/clinical-applications-of-intravenous-immunoglobulins-in-child-neurology
#9
Maria Gogou, Efimia Papadopoulou-Alataki, Martha Spilioti, Sofia Alataki, Athanasios Evangeliou
BACKGROUND: While there are guidelines for the use of intravenous immunoglobulins in children with Guillain-Barre syndrome and myasthenia gravis based on high-level evidence studies, data is fewer for the majority of neurologic disorders in this age group. Neuronal antibodies are detected in children with seizures of autoimmune etiology. Intravenous immunoglobulins with their broad immunomodulatory mechanism of action could be ideally effective in different forms of immune-dysregulated intractable epilepsies such as autoimmune epilepsy and autoimmune Rasmussen encephalitis...
September 15, 2017: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/28914077/decision-algorithms-for-direct-oral-anticoagulant-use-in-patients-with-nonvalvular-atrial-fibrillation-a-practical-guide-for-neurologists
#10
Isabella Canavero, Giuseppe Micieli, Maurizio Paciaroni
Direct oral anticoagulants (DOACs) are valid alternative options to vitamin K antagonists due to their limited interactions with drugs or food and the fact that they do not require regular coagulation monitoring. To this regard, recent practice guidelines recommend that DOACs should be considered as first-line anticoagulant therapy for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). This review (1) outlines current international guidelines for the management of DOACs to prevent stroke in patients with NVAF, (2) outlines indications for elderly patients as well as specific settings including acute coronary syndromes and intracranial hemorrhage, and (3) offers a practical guide for the use of DOACs in neurological settings...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28906404/ticagrelor-induced-life-threatening-bleeding-via-the-cyclosporine-mediated-drug-interaction-a-case-report
#11
Chi Zhang, Long Shen, Min Cui, Xiaoyan Liu, Zhichun Gu
RATIONALE: Ticagrelor has become one of the first-line antiplatelet agents in acute coronary syndrome (ACS) patients recommend by the guideline due to its more potent and predictable antiplatelet effect. However, bleeding is still a severe drug adverse reaction of ticagrelor therapy. We report a first case on ticagrelor-induced life-threatening bleeding via the cyclosporine-mediated drug interaction. PATIENT CONCERNS: A 58-year-old Chinese male who received cyclosporine 200 mg daily 5 years after renal transplantation...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28906253/latest-insights-on-food-protein-induced-enterocolitis-syndrome-an-emerging-medical-condition
#12
REVIEW
L Vila Sexto
Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated gastrointestinal food hypersensitivity, characterized by profuse vomiting, frequently associated to pallor or/and lethargy that appears within 1 to 3 hours after ingestion of the offending food. There is a less frequent chronic form of FPIES, presenting with protracted vomiting, diarrhea or both, accompanied by poor growth. Although FPIES is considered a rare allergic disorder, in the last few years there have been an increasing number of reports about it indicating if not a real increase in incidence, at least an increased awareness of this condition by pediatricians...
August 29, 2017: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/28905806/oesophageal-perforation-therapeutic-and-diagnostics-challenge-retrospective-single-center-case-report-analysis-2009-2015
#13
Piotr Misiak, Sławomir Jabłoński, Łukasz Piskorz, Lechosław Dorożała, Artur Terlecki, Szymon Wcisło
BACKGROUND: Esophageal perforation is a life-threatening condition of a complex etiology. No clear guidelines are available regarding the management of this condition. In this study, we review publications related to esophageal perforation, and analyze patients treated for this condition at our Department of Thoracic, General and Oncological Surgery. OBJECTIVE: The objective of the study was to retrospectively assess and analyze management methods for esophageal perforations of different etiologies...
August 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28904293/characteristics-of-electromechanical-window-in-anesthetized-rabbit-models-of-short-qt-and-long-qt-syndromes
#14
Vudhiporn Limprasutr, Nakkawee Saengklub, Pradtana Meedech, Anusak Kijtawornrat, Robert L Hamlin
The current regulatory guidelines recommend the use of QT interval to assess the risk of arrhythmogenic potential of new chemical entities. Recently, the electromechanical window (EMW), the difference in duration between electrical and mechanical systole, has been proposed as markers for drug-induced torsades de pointes (TdP); however, data of EMW in short QT model are not available. This study aimed to characterize the EMW as a marker for drug-induced ventricular arrhythmias in anesthetized rabbit model of long QT syndrome type 2 (LQT2) and short QT syndrome (SQTS) infused with reference compounds known to lengthen or shorten QT intervals...
2017: Journal of Toxicological Sciences
https://www.readbyqxmd.com/read/28903413/a-novel-heterozygous-germline-deletion-in-msh2-gene-in-a-five-generation-chinese-family-with-lynch-syndrome
#15
Bin Wu, Wuyang Ji, Shengran Liang, Chao Ling, Yan You, Lai Xu, Min-Er Zhong, Yi Xiao, Hui-Zhong Qiu, Jun-Yang Lu, Santasree Banerjee
Lynch syndrome (LS) is one of the most common familial forms of colorectal cancer predisposing syndrome with an autosomal dominant mode of inheritance. LS is caused by the germline mutations in DNA mismatch repair (MMR) genes including MSH2, MLH1, MSH6 and PMS2. Clinically, LS is characterized by high incidence of early-onset colorectal cancer as well as endometrial, small intestinal and urinary tract cancers, usually occur in the third to fourth decade of the life. Here we describe a five generation Chinese family with LS clinically diagnosed according to the Amsterdam II criteria...
August 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28902230/chronic-kidney-disease-and-metabolic-syndrome-as-risk-factors-for-cardiovascular-disease-in-a-primary-care-program
#16
Suzana Greffin, Mauro Barros André, Jorge Paulo Strogoff de Matos, Hye Chung Kang, Antonio José Lagoeiro Jorge, Maria Luiza Garcia Rosa, Jocemir Ronaldo Lugon
Introduction: Cardiovascular disease (CVD) is especially prevalent in patients with chronic kidney disease (CKD). Objective: To evaluate the role of CKD and metabolic syndrome (MS), which is a cluster of risk factors for CVD, as predictors of CVD. Methods: Observational, cross-sectional study with a random sample aged 45 or more years extracted from the population assisted by the primary care program in Niterói city in the state of Rio de Janeiro, Brazil...
August 28, 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28898247/prevalence-of-acromegaly-in-patients-with-symptoms-of-sleep-apnea
#17
Gemma Sesmilo, Eugenia Resmini, Marcel Sambo, Concepción Blanco, Fernando Calvo, Fernando Pazos, Pablo Fernández-Catalina, Purificación Martínez de Icaya, Concepción Páramo, Carmen Fajardo, Mónica Marazuela, Cristina Álvarez-Escolá, Juan Jose Díez, Verónica Perea
Acromegaly is a rare disease with nonspecific symptoms with acral enlargement being almost universally present at diagnosis. The estimated prevalence is 40-125 cases/million but targeted universal screening studies have found a higher prevalence (about 10 fold). The aim of the ACROSAHS study was to investigate the prevalence of acromegaly and acromegaly comorbidities in patients with sleep apnea symptoms and acral enlargement. ACROSAHS was a Spanish prospective non-interventional epidemiological study in 13 Hospital sleep referral units...
2017: PloS One
https://www.readbyqxmd.com/read/28895701/management-of-cirrhotic-ascites-in-children-review-and-recommendations-part-2-electrolyte-disturbances-nonelectrolyte-disturbances-therapeutic-options
#18
David F Bes, M Cristina Fernández, Ivone Malla, Horacio A Repetto, Daniel Buamscha, Susana López, Roxana Martinitto, Miriam Cuarterolo, Fernando Alvarez
Ascites is a major complication of cirrhosis. There are several evidence-based articles and guidelines for the management of adults, but few data have been published in relation to children. In the case of a pediatric patient with cirrhotic ascites (PPCA), the following questions are raised: How are the clinical assessment and ancillary tests performed? When is ascites considered refractory? How is it treated? Should fresh plasma and platelets be infused before abdominal paracentesis to prevent bleeding? What are the hospitalization criteria? What are the indicated treatments? What complications can patients develop? When and how should hyponatremia be treated? What are the diagnostic criteria for spontaneous bacterial peritonitis? How is it treated? What is hepatorenal syndrome? How is it treated? When should albumin be infused? When should fluid intake be restricted? The recommendations made here are based on pathophysiology and suggest the preferred approach to diagnostic and therapeutic aspects, and preventive care...
October 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28894560/poems-syndrome-an-update
#19
REVIEW
Andrea Nozza
POEMS syndrome is a rare, chronic and disabling condition. The causes of this condition remain unknown; however, chronic overproduction of proinflammatory cytokines appears to be a major contributor. Early diagnosis is essential to start treatment before the clinical state of the patient becomes compromised. A complete evaluation of the disease at its onset is critical to the treatment decision. In localized disease, curative doses of radiation (50 Gy) is the recommended therapy. On the other hand, patients with disseminated disease should be given systemic therapy...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/28893843/timing-of-angiography-and-outcomes-in-high-risk-patients-with-non-st-segment-elevation-myocardial-infarction-managed-invasively-insights-from-the-tao-trial
#20
Pierre Deharo, Gregory Ducrocq, Christoph Bode, Marc Cohen, Thomas Cuisset, Shamir Mehta, Charles V Pollack, Stephen D Wiviott, Yedid Elbez, Marc Sabatine, P Gabriel Steg
Background -In patients with non ST-elevation myocardial infarction (NSTEMI) and Global Registry of Acute Coronary Events (GRACE) score >140, coronary angiography (CAG) is recommended by European and American guidelines within 24h. We sought to study the association of a "very early" (i.e. ≤12h), early (12-24h) and delayed (>24h) CAG in NSTEMI with GRACE score >140 with ischemic outcomes. Methods -The Treatment of Acute coronary syndrome with Otamixaban (TAO) trial randomized patients with NSTEMI and CAG scheduled within 72h to heparin plus eptifibatide versus otamixaban...
September 11, 2017: Circulation
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