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https://www.readbyqxmd.com/read/29037012/medical-treatment-of-intracranial-atherosclerosis-an-update
#1
REVIEW
Jong S Kim, Oh Young Bang
For patients with symptomatic intracranial atherosclerosis (ICAS), antithrombotic agents are the mainstay of therapy. Anticoagulation (warfarin) is not widely used since it is not more effective than aspirin and carries a high risk of bleeding. New oral anticoagulants are showing promise, but their use has not been investigated in appropriate clinical trials. Since the recurrent stroke risk is high with aspirin monotherapy, dual antiplatelets are considered in the early stage of symptomatic ICAS. Based on the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) and Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) results, aspirin plus clopidogrel has been recommended...
September 2017: Journal of Stroke
https://www.readbyqxmd.com/read/29036827/validation-by-magnetic-resonance-imaging-of-the-diagnostic-potential-of-a-heptapeptide-functionalized-imaging-probe-targeted-to-amyloid-%C3%AE-and-able-to-cross-the-blood-brain-barrier
#2
Séverine André, Emilie Ansciaux, Elamine Saidi, Lionel Larbanoix, Dimitri Stanicki, Denis Nonclercq, Luce Vander Elst, Sophie Laurent, Robert N Muller, Carmen Burtea
The diagnosis of Alzheimer's disease (AD) is a critical step in the management of patients. We have developed a non-invasive diagnosis tool based on magnetic resonance molecular imaging (MRMI) of amyloid-β peptide using ultra-small particles of iron oxide (USPIO) functionalized with a disulfide constrained cyclic heptapeptide (PHO) identified by phage display (USPIO-PHO). After previously demonstrating the optimal pharmacologic properties of USPIO-PHO and its capacity to cross the blood-brain barrier (BBB), the ability of USPIO-PHO to target amyloid plaques (AP) by MRMI has been validated in the present work on AD transgenic mice...
October 12, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29036747/prevention-of-multidrug-resistant-infections-from-contaminated-duodenoscopes-position-statement-of-the-european-society-of-gastrointestinal-endoscopy-esge-and-european-society-of-gastroenterology-nurses-and-associates-esgena
#3
Ulrike Beilenhoff, Holger Biering, Reinhard Blum, Jadranka Brljak, Monica Cimbro, Jean-Marc Dumonceau, Cesare Hassan, Michael Jung, Christiane Neumann, Michael Pietsch, Lionel Pineau, Thierry Ponchon, Stanislav Rejchrt, Jean-François Rey, Verona Schmidt, Jayne Tillett, Jeanin van Hooft
Patients should be informed about the benefits and risks of endoscopic retrograde cholangiopancreatography (ERCP)Only specially trained and competent personnel should carry out endoscope reprocessing.Manufacturers of duodenoscopes should provide detailed instructions on how to use and reprocess their equipment.In the case of modifications to their equipment, manufacturers should provide updated instructions for use.Detailed reprocessing protocols based on the manufacturer's instructions for use should clearly lay out the different reprocessing steps necessary for each endoscope model...
October 16, 2017: Endoscopy
https://www.readbyqxmd.com/read/29036406/effects-of-computerized-decision-support-system-implementations-on-patient-outcomes-in-inpatient-care-a-systematic-review
#4
Julian Varghese, Maren Kleine, Sophia Isabella Gessner, Sarah Sandmann, Martin Dugas
Objectives: To systematically classify the clinical impact of computerized clinical decision support systems (CDSSs) in inpatient care. Materials and Methods: Medline, Cochrane Trials, and Cochrane Reviews were searched for CDSS studies that assessed patient outcomes in inpatient settings. For each study, 2 physicians independently mapped patient outcome effects to a predefined medical effect score to assess the clinical impact of reported outcome effects. Disagreements were measured by using weighted kappa and solved by consensus...
September 23, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29035978/use-of-blood-biomarkers-in-the-assessment-of-sports-related-concussion-a-systematic-review-in-the-context-of-their-biological-significance
#5
Brendan OʼConnell, Áine M Kelly, David Mockler, Matej Orešič, Karl Denvir, Garreth Farrell, Damir Janigro, Fiona Wilson
OBJECTIVES: To critically review current knowledge on the positive and negative predictive value of blood biomarkers for concussion; to illustrate the clinical and biological contexts that help evaluate the use of these markers in sport-related traumatic brain injuries (TBIs). METHODS: This systematic review was performed in accordance with PRISMA guidelines. We reviewed the measurement, clinical utility, endpoint, and biological significance of blood biomarkers in concussion...
October 12, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29035969/effects-of-medical-food-leucine-content-in-the-management-of-methylmalonic-and-propionic-acidemias
#6
Jennifer G Myles, Irini Manoli, Charles P Venditti
PURPOSE OF REVIEW: The current review highlights the varied effects of medical foods high in leucine (Leu) and devoid of valine (Val) and isoleucine (Ile) in the management of methylmalonic acidemia (MMA) and propionic acidemia and cobalamin C (cblC) deficiency, aiming to advance dietary practices. RECENT FINDINGS: Leu is a key metabolic regulator with a multitude of effects on different organ systems. Recent observational studies have demonstrated that these effects can have unintended consequences in patients with MMA as a result of liberal use of medical foods...
October 14, 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29034016/improved-outcomes-for-ruptured-abdominal-aortic-aneurysms-using-integrated-management-involving-endovascular-clamping-endovascular-replacement-and-open-abdominal-decompression
#7
Chikashi Aoki, Norihiro Kondo, Yoshiaki Saito, Satoshi Taniguchi, Wakako Fukuda, Kazuyuki Daitoku, Ikuo Fukuda
Objective: Endovascular repair has become the treatment of choice for ruptured abdominal aortic aneurysms (RAAAs). To improve surgical outcomes, preoperative management is important. In 2011, we introduced integrated management, which involves endovascular aneurysm repair, stabilization of hemodynamics by endovascular clamping, and open abdominal decompression to address abdominal compartment syndrome (ACS). Methods: To evaluate the efficacy of this management strategy, 62 patients who had undergone emergency surgery for an RAAA were analyzed retrospectively: group A (n=39), where an old strategy was used, and group B (n=23), where integrated management was introduced...
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29033904/an-improved-in-house-maldi-tof-ms-protocol-for-direct-cost-effective-identification-of-pathogens-from-blood-cultures
#8
Menglan Zhou, Qiwen Yang, Timothy Kudinha, Liying Sun, Rui Zhang, Chang Liu, Shuying Yu, Meng Xiao, Fanrong Kong, Yupei Zhao, Ying-Chun Xu
Background: Bloodstream infection is a major cause of morbidity and mortality in hospitalized patients worldwide. Delays in the identification of microorganisms often leads to a poor prognosis. The application of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) directly to blood culture (BC) broth can potentially identify bloodstream infections earlier, and facilitate timely management. Methods: We developed an "in-house" (IH) protocol for direct MALDI-TOF MS based identification of organisms in positive BCs...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29033725/assessment-of-patient-controlled-analgesia-versus-intermittent-opioid-therapy-to-manage-sickle-cell-disease-vaso-occlusive-crisis-in-adult-patients
#9
Alaa Al-Anazi, Lowloa Al-Swaidan, Maha Al-Ammari, Tariq Al-Debasi, Abdulmalik M Alkatheri, Shmeylan Al-Harbi, Aiman A Obaidat, Abdulkareem M Al-Bekairy
BACKGROUND: Vaso-occlusive crisis (VOC) is one of the acute complications of sickle-cell disease (SCD). Treatment mainly relies on hydration and pain control by analgesics. The specific aim of this study was to assess potential health outcomes within the first 72 h of admission between intermittent and patient-controlled analgesia (PCA) by opioids among VOC patients. METHODS: A retrospective chart review study was conducted to determine SCD patients with VOC. Using the hospital electronic system, the following data were collected: patient's age, gender, blood pressure, heart rate, respiratory rate, oxygen saturation, and pain score on admission and daily for 3 days as well as the cumulative opioid analgesic dose for 72 h which is reported as morphine equivalent...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033597/reasons-for-discontinuation-of-glp1-receptor-agonists-data-from-a-real-world-cross-sectional-survey-of-physicians-and-their-patients-with-type-2-diabetes
#10
Mirko V Sikirica, Alan A Martin, Robert Wood, Andrea Leith, James Piercy, Victoria Higgins
AIM: Nonadherence to glucagon-like peptide-1 receptor agonists (GLP1 RAs) is relatively common among patients with type 2 diabetes mellitus (T2DM). This study sought to identify reasons why patients discontinue GLP1 RAs. MATERIALS AND METHODS: Retrospective data from the Adelphi Diabetes Disease Specific Programme were used. Physicians managing patients with T2DM were surveyed via face-to-face interviews, and patients treated for T2DM were surveyed via self-completed questionnaires...
2017: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/29033550/coach-to-cope-feasibility-of-a-life-coaching-program-for-young-adults-with-cystic-fibrosis
#11
Karin Bæk Knudsen, Tacjana Pressler, Laust Hvas Mortensen, Mary Jarden, Kirsten Arntz Boisen, Marianne Skov, Alexandra L Quittner, Terese Lea Katzenstein
BACKGROUND: Over the last two decades, lifespan has increased significantly for people living with cystic fibrosis (CF). However, several studies have demonstrated that many young adults with CF report mental health problems and poor adherence to their prescribed treatments, challenging their long-term physical health. Treatment guidelines recommend interventions to improve adherence and self-management. The aim of this study was to test the feasibility of a life coaching intervention for young adults with CF...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29033108/clinical-course-in-infants-diagnosed-with-transient-tachypnea-of-newborn-a-clinical-trial-assessing-the-role-of-conservative-versus-conventional-management
#12
M Dehdashtian, M Aletayeb, A Malakian, M R Aramesh, H Malvandi
BACKGROUND: Transient tachypnea of the newborn (TTN) is a respiratory disorder secondary to inadequate or delayed clearance of lung fluids. Early symptoms of the disease are indistinguishable from neonatal respiratory distress syndrome, pneumonia, and persistent pulmonary hypertension. Therefore, these newborns, in addition to receiving conservative management, receive antibiotics until blood cultures provide definite results. In this study, we assessed the clinical course of neonates diagnosed with TTN who received conventional versus conservative management...
October 9, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29033046/eschar-removal-by-bromelain-based-enzymatic-debridement-nexobrid-%C3%A2-in-burns-an-european-consensus
#13
Christoph Hirche, Antonella Citterio, Henk Hoeksema, Ján Koller, Martina Lehner, José Ramón Martinez, Stan Monstrey, Alexandra Murray, Jan A Plock, Frank Sander, Alexandra Schulz, Benjamin Ziegler, Ulrich Kneser
Early debridement and/or eschar removal is regarded as a significant step in the treatment of deep partial and full thickness burns. It aims to control wound bioburden and allows early wound closure by conservative treatment or skin grafting. Preservation of viable dermis accompanied by early wound closure, is regarded as a necessary step to reduce scar related complication, e.g. functional limitations and/or unaesthetic scar formation. Aside from the classical techniques of surgical excision as tangential excision for eschar removal, hydro-surgery, maggot therapy, laser, enzymatic debridement have been described as additional techniques in the burn surgeon's armamentarium...
October 12, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29033031/the-next-challenges-for-optimal-reperfusion-in-the-era-of-mechanical-thrombectomy
#14
REVIEW
M Mazighi
The therapeutic management of acute ischemic stroke has changed tremendously over the past few years. Mechanical thrombectomy in addition to intravenous tissue plasminogen activator (t-PA) is currently the standard of care for patients experiencing acute ischemic stroke as a consequence of large vessel occlusion of the anterior circulation. Yet, despite strong evidence supporting such a therapeutic approach, several issues remain a source of debate, such as the need for intravenous t-PA, the optimal target for blood pressure levels and the opportunity for additional antithrombotic therapies to improve reperfusion...
October 12, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/29032804/-clinical-relevance-of-esr1-circulating-mutations-detection-in-hormone-receptor-positive-metastatic-breast-cancer
#15
REVIEW
Florian Clatot, Anne Perdrix, David Sefrioui, Nasrin Sarafan-Vasseur, Frédéric Di Fiore
If hormone therapy is a key treatment for hormone receptor positive advanced breast cancers, secondary resistance occurs as a rule. Recently, acquired alterations of the ESR1 gene have been identified as a mechanism of resistance on aromatase inhibitor (AI) treatment. The selective pressure by AI exposure during the metastatic setting triggers the emergence of ESR1 activating mutations. In that context, the "liquid biopsy" concept has been used to detect this molecular resistance before progression. Thus, the ESR1 circulating mutation detection will soon be used in daily practice to help monitoring patients on AI treatment and provide an early change for specific therapies that still have to be determined in prospective clinical trials...
October 9, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/29032756/antidiabetic-drugs-as-antihypertensives-new-data-on-the-horizon
#16
Vassiliki Mamakou, Ioanna Eleftheriadou, Niki Katsiki, Konstantinos Makrilakis, Konstantinos Tsioufis, Nikoalos Tentolouris
The prevalence of type 2 diabetes mellitus (T2DM) increases worldwide, forcing for more research in the area of the optimal diabetes management. Cardiovascular disease (CVD) remains the commonest cause of death in individuals with T2DM. Besides hyperglycemia, an explanation for the increased mortality in this population is the increased prevalence of comorbidities, such as hypertension and dyslipidemia. Recent population-based studies described a prevalence of hypertension greater than 80% in patients with T2DM...
October 10, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29032158/location-affects-the-management-of-liver-haemangioma-a-retrospective-cohort-study
#17
Xiaolei Liu, Zhiying Yang, Haidong Tan, Li Xu, Liguo Liu, Jia Huang, Shuang Si, Yongliang Sun
BACKGROUND: The location of liver haemangioma may affect surgical decisions, but no study has ever examined this issue. METHODS: A retrospective study was performed on 338 liver haemangioma patients who visited at clinic. The collected data included demographics, location, symptoms and whether surgical treatment was performed. For patients with surgical treatment, the collected data included radiologic characteristics, surgical procedures, surgical variables, postoperative stay, morbidity, and mortality...
October 12, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29032116/mechanisms-of-action-for-%C3%AE-1-adrenoceptor-blockers-in-storage-symptoms-with-new-insights-into-the-micturition-reflex
#18
REVIEW
Tsuyoshi Hattori, Kimio Sugaya
Elderly patients suffering from lower urinary tract symptoms with benign prostatic hyperplasia (BPH) are widely prescribed α1-adrenoceptor blockers (α1-blockers) to improve voiding and storage symptoms. The mechanism of action for improvements in voiding symptoms is well understood; tonus of the urethra and prostate are decreased and urinary flow rate is increased by α1-blockers. However, the mechanisms underlying storage symptoms have remained unclear, although detrusor hyperactivity has been identified as a significant factor...
October 11, 2017: Life Sciences
https://www.readbyqxmd.com/read/29032050/positive-predictive-value-estimates-for-cell-free-noninvasive-prenatal-screening-from-data-of-a-large-referral-genetic-diagnostic-laboratory
#19
Andrea K Petersen, Sau Wai Cheung, Janice L Smith, Weimin Bi, Patricia A Ward, Sandra Peacock, Alicia Braxton, Ignatia B van den Veyver, Amy M Breman
BACKGROUND: Since its debut in 2011, cell-free fetal DNA (cffDNA) screening has undergone rapid expansion with respect to both utilization and coverage. However, conclusive data regarding the clinical validity and utility of this screening tool, both for the originally included common autosomal and sex-chromosomal aneuploidies as well as the more recently added chromosomal microdeletion syndromes, has lagged behind. Thus, there is a continued need to educate clinicians and patients about the current benefits and limitations of this screening tool to inform pre and post-test counseling, pre/perinatal decision making and medical risk assessment/management...
October 12, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29031173/an-unusual-case-of-transpelvic-impalement-injury-a-case-report
#20
Mushrek Alani, Saeed Mahmood, Ayman El-Menyar, Sajid Atique, Hassan Al-Thani, Ruben Peralta
INTRODUCTION: Impalement injury is a rare type of mechanical injury following forceful insertion of projecting object into the body. Careful planning for removal of the impaling object is essential to decrease the blood loss and preserve the function of the injured organ. PRESENTATION OF CASE: A 27 year-old male fell from 4m height over a U shaped projecting up metallic bar. The bar penetrated the left side of the pelvis and traversed through the left iliac bone causing a comminuted fracture in the supra-acetabular region extending to the left psoas muscle, injuring the viscera and causing fracture of the right femur...
October 5, 2017: International Journal of Surgery Case Reports
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