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Yves Henchoz, Laurence Seematter-Bagnoud, David Nanchen, Christophe Büla, Armin von Gunten, Jean-Francois Démonet, Brigitte Santos-Eggimann
BACKGROUND: Multimorbidity, or co-occurrence of several chronic diseases, has major consequences in terms of function, quality of life and mortality. Recent advances suggest that the aetiology of multimorbidity includes a life-long process. The purpose of this study was to determine the association between childhood adversity and multimorbidity in community-dwelling older adults, and to investigate variation in participants born immediately before, during and at the end of the Second World War...
October 9, 2018: Archives of Gerontology and Geriatrics
Shigeki Kubota, Tetsuya Abe, Hideki Kadone, Yukiyo Shimizu, Toru Funayama, Hiroki Watanabe, Aiki Marushima, Masao Koda, Yasushi Hada, Yoshiyuki Sankai, Masashi Yamazaki
CONTEXT/OBJECTIVE: The hybrid assistive limb (HAL) is a wearable exoskeleton robot that assists walking and lower limb movements via real-time actuator control. Our aim was to clarify the safety and feasibility of using the HAL robotic suit for rehabilitation in patients with severe thoracic myelopathy due to ossification of the posterior longitudinal ligament (T-OPLL). DESIGN: Uncontrolled case series; pre- and post-intervention measurement. SETTING: In-patient rehabilitation unit...
October 18, 2018: Journal of Spinal Cord Medicine
Stanley G Rockson, Wen Tian, Xinguo Jiang, Tatiana Kuznetsova, Francois Haddad, Jamie Zampell, Babak Mehrara, Joshua P Sampson, Leslie Roche, Jinah Kim, Mark R Nicolls
BACKGROUND: Lymphedema is a common condition affecting millions around the world that still lacks approved medical therapy. Because ketoprofen, an NSAID, has been therapeutic in experimental lymphedema, we evaluated its efficacy in humans. METHODS: We first performed an exploratory open-label trial. Patients with either primary or secondary lymphedema received ketoprofen 75 mg by mouth 3 times daily for 4 months. Subjects were evaluated for changes in histopathology, with skin thickness, limb volume, and tissue bioimpedance changes serving as secondary endpoints...
October 18, 2018: JCI Insight
Anggi Gayatri, Nafrialdi Nafrialdi, Rahajuningsih D Setiabudy, Raymond R Tjandrawinata, Andika Rachman, Melva Louisa
BACKGROUND: DLBS1033 is a bioactive protein fraction extracted from Lumbricus rubellus, with fibrinogenolytic, fibrinolytic and anti-aggregation activities reported in an in vitro study. Plasma half-life is an important parameter to calculate its dose. This study was conducted to evaluate the biological half-life of DLBS1033 by measuring serial plasmin-antiplasmin (PAP) complex. PAP complex is a stable and inactive compound as a result of fibrinolysis process. METHODS: this was an open-label clinical trial in healthy adult subjects...
July 2018: Acta Medica Indonesiana
Harrina Erlianti Rahardjo, Firtantyo Adi Syahputra, Putri Iradita Islianti, Faisal Abdi Matondang
BACKGROUND: urinary tract infection (UTI) is often treated in daily practice as overactive bladder (OAB) by giving anticholinergic, the recommended treatment options of OAB. However, anticholinergic application for UTI symptoms relief has never been investigated. To our knowledge, this study was the first randomized trial which investigate anticholinergic use for UTI treatment. This study aimed to evaluate whether additional anticholinergic is beneficial alongside an empiric antibiotic therapy in reducing symptoms and tolerable for females with uncomplicated UTI...
July 2018: Acta Medica Indonesiana
Ahmed Abbas, Yusuf A Rajabally
Intravenous immunoglobulin (IVIg) forms a cornerstone of effective treatment for acute and chronic inflammatory neuropathies, with a class I evidence base in Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN). It is generally considered to be a safe therapy however there are several recognised complications which are reviewed in this article. Most adverse events are immediate and mild such as headache, fever and nausea although more serious immediate reactions such as anaphylaxis may rarely occur...
October 17, 2018: Current Drug Safety
Antonio C Madruga Neto, Vitor O Brunaldi, Ossamu Okazaki, Marco A Santo Filho, Antônio A Miranda Neto, Vera L Anapaz, Eduardo G H de Moura
No abstract text is available yet for this article.
October 17, 2018: Endoscopy
Hee-Young Yoon, Dong Soon Kim, Jin Woo Song
BACKGROUND: Although phase 3 trials showed significant efficacy and acceptable safety profiles for pirfenidone in mild-to-moderate idiopathic pulmonary fibrosis (IPF), data on advanced IPF are limited. OBJECTIVES: The study aimed to evaluate the efficacy and safety of pirfenidone in advanced IPF patients. METHODS: The clinical data of 138 IPF patients (advanced group: 27%) treated with pirfenidone were retrospectively reviewed and compared between advanced and non-advanced groups...
October 17, 2018: Respiration; International Review of Thoracic Diseases
Sun-Young Kim, Ji-Young Jeon, Shin Jung Park, Min-Gul Kim
This study aimed to compare the pharmacokinetic profile of combined CKD-395 0.5/1000 mg treatment with that of the coadministration of lobeglitazone sulfate 0.5 mg and metformin hydrochloride (HCl) extended-release (XR) 1000 mg and assess the effect of food on the pharmacokinetics of CKD-395 0.5/1000 mg. Two clinical trials were conducted as part of an open-label, single-dose, randomized, 2-period, 2-sequence crossover study. In study 1, a total of 26 subjects received either CKD-395 0.5/1000 mg as a test drug or coadministration of lobeglitazone sulfate 0...
October 17, 2018: Clinical Pharmacology in Drug Development
Zhenmi Liu, Jo C Dumville, Robert J Hinchliffe, Nicky Cullum, Fran Game, Nikki Stubbs, Michael Sweeting, Frank Peinemann
BACKGROUND: Foot wounds in people with diabetes mellitus (DM) are a common and serious global health issue. People with DM are prone to developing foot ulcers and, if these do not heal, they may also undergo foot amputation surgery resulting in postoperative wounds. Negative pressure wound therapy (NPWT) is a technology that is currently used widely in wound care. NPWT involves the application of a wound dressing attached to a vacuum suction machine. A carefully controlled negative pressure (or vacuum) sucks wound and tissue fluid away from the treated area into a canister...
October 17, 2018: Cochrane Database of Systematic Reviews
Tong Zhang, Hongbo Ju, Haojun Chen, Wen Wen
Paricalcitol and calcitriol are widely used for the treatment of secondary hyperparathyroidism in dialysis patients. We conducted a systematic review and meta-analysis to compare the efficacy and safety of paricalcitol and calcitriol for secondary hyperparathyroidism in dialysis patients. PubMed, EMbase, Web of Science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCT) assessing the efficacy of paricalcitol and calcitriol for secondary hyperparathyroidism in dialysis patients are included...
October 16, 2018: Therapeutic Apheresis and Dialysis
Magnus T Dillon, Lorna Grove, Katie L Newbold, Heather Shaw, Nicholas F Brown, Jeanne Mendell, Shuquan Chen, Robert A Beckman, Anne Jennings, Marivic Ricamara, Jonathan Greenberg, Martin Forster, Kevin J Harrington
BACKGROUND: Patritumab plus cetuximab with platinum as first-line therapy for patients with recurrent and/or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN) was evaluated for safety and to determine the recommended phase-II combination dose. METHODS: Patients aged ≥18 years with confirmed R/M SCCHN received intravenous patritumab (18-mg/kg loading dose [LD]); 9-mg/kg maintenance dose [MD] every 3 weeks [q3w]) + cetuximab (400-mg/m2 LD; 250-mg/m2 MD weekly) + cisplatin (100 mg/m2 q3w) or carboplatin (area under the curve [AUC] of 5) for 6 cycles or until toxicity, disease progression, or withdrawal...
October 16, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
John P Bourke, Teofila Bueser, Rosaline Quinlivan
BACKGROUND: The dystrophinopathies include Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD), and X-linked dilated cardiomyopathy (XLDCM). In recent years, co-ordinated multidisciplinary management for these diseases has improved the quality of care, with early corticosteroid use prolonging independent ambulation, and the routine use of non-invasive ventilation signficantly increasing survival. The next target to improve outcomes is optimising treatments to delay the onset or slow the progression of cardiac involvement and so prolong survival further...
October 16, 2018: Cochrane Database of Systematic Reviews
Graham Devereux, Seonaidh Cotton, Shona Fielding, Nicola McMeekin, Peter J Barnes, Andrew Briggs, Graham Burns, Rekha Chaudhuri, Henry Chrystyn, Lisa Davies, Anthony De Soyza, Simon Gompertz, John Haughney, Karen Innes, Joanna Kaniewska, Amanda Lee, Alyn Morice, John Norrie, Anita Sullivan, Andrew Wilson, David Price
Importance: Chronic obstructive pulmonary disease (COPD) is a major global health issue and theophylline is used extensively. Preclinical investigations have demonstrated that low plasma concentrations (1-5 mg/L) of theophylline enhance antiinflammatory effects of corticosteroids in COPD. Objective: To investigate the effectiveness of adding low-dose theophylline to inhaled corticosteroids in COPD. Design, Setting, and Participants: The TWICS (theophylline with inhaled corticosteroids) trial was a pragmatic, double-blind, placebo-controlled, randomized clinical trial that enrolled patients with COPD between February 6, 2014, and August 31, 2016...
October 16, 2018: JAMA: the Journal of the American Medical Association
Robert J Campbell, Sherif R El-Defrawy, Sudeep S Gill, Marlo Whitehead, Erica de L P Campbell, Philip L Hooper, Chaim M Bell, Martin W Ten Hove
Importance: Evidence suggests that the quality of some aspects of care provided by physicians may decrease during their late career stage. However, to our knowledge, data regarding the association of advancing surgeon career phase with cataract surgical outcomes have been lacking. Objective: To investigate whether an increase in cataract surgical adverse events occurs during later surgeon career stages. Design, Setting, and Participants: This population-based study of 499 650 cataract operations performed in Ontario, Canada, between January 1, 2009, and December 31, 2013, investigated the association between late surgeon career stage and the risk of surgical adverse events...
October 11, 2018: JAMA Ophthalmology
Felix J Hüttner, Pascal Probst, Hannes G Kenngott, Phillip Knebel, Thilo Hackert, Alexis Ulrich, Markus W Büchler, Markus K Diener
BACKGROUND: Postoperative pancreatic fistula (POPF) remains a frequent problem especially after distal pancreatectomy. The application of 2-octyl cyanoacrylate showed promising results in the reduction of POPF after pancreatoduodenectomy prompting an expansion of this technique to distal pancreatectomy. Thus, the objective of the current study was to assess safety, feasibility and preliminary efficacy of an intraoperative 2-octyl cyanoacrylate application after distal pancreatectomy. METHODS: Between April 2015 and June 2016 adult patients scheduled for elective distal pancreatectomy were considered eligible for the study...
2018: PloS One
Carine Claeys, Vijayalakshmi Chandrasekaran, José García-Sicilia, Roman Prymula, Javier Díez-Domingo, Jerzy Brzostek, Josep Marès-Bermúdez, Federico Martinón-Torres, Andrew J Pollard, Renata Růžková, Alfonso Carmona Martinez, Angels Ulied, Mariano Miranda Valdivieso, Saul N Faust, Matthew D Snape, Damien Friel, Thierry Ollinger, Jyoti Soni, Anne Schuind, Ping Li, Bruce L Innis, Varsha K Jain
BACKGROUND: It has not yet been demonstrated whether two doses of inactivated quadrivalent influenza vaccine (IIV4) prime a booster response in infants. We evaluated the anamnestic immune response to an IIV4 in children aged 17-48 months. METHODS: Children were randomized to two doses of IIV4 or control in the primary phase III study (NCT01439360). One year later, in an open-label revaccination extension study (NCT01702454), a subset of children who received IIV4 in the primary study (primed group) received one IIV4 dose and children who received control in the primary study (unprimed) received two IIV4 doses 28 days apart...
October 15, 2018: Pediatric Infectious Disease Journal
William F Lavelle, K Daniel Riew, Allan Levi, Jeffrey E Florman
STUDY DESIGN: Prospective, randomized multicenter IDE Trial between May 2002 and October 2004. OBJECTIVE: Report on the 10-year safety and efficacy of BRYAN® cervical disc (CDA). SUMMARY OF BACKGROUND DATA: Cervical disc arthroplasty (CDA) is a potential alternative for anterior cervical decompression and fusion (ACDF) with the hope that maintenance of motion may decrease the likelihood of adjacent segment disease. METHODS: This is an analysis of a FDA investigation comparing CDA with ACDF for single level patients...
October 15, 2018: Spine
Y Umezawa, H Torisu-Itakura, Y Morisaki, H ElMaraghy, K Nakajo, N Akashi, H Saeki
BACKGROUND: Long-term management of moderate-to-severe psoriasis is usually discussed in terms of continuous administration; however, there are many situations in clinical practice where treatment may be withdrawn with subsequent retreatment. OBJECTIVE: To assess the clinical course after ixekizumab treatment withdrawal and retreatment, as well as the effectiveness of ixekizumab retreatment, in Japanese patients with plaque psoriasis. METHODS: This single-arm, open-label study (UNCOVER-J; NCT01624233) comprised 78 patients with plaque psoriasis...
October 16, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Helen Tilbrook, Laura Clark, Liz Cook, Martin Bland, Hannah Buckley, Ian Chetter, Jo Dumville, Chris Fenner, Rachael Forsythe, Rhian Gabe, Keith Harding, Alison Layton, Ellie Lindsay, Catriona McDaid, Christine Moffatt, Debbie Rolfe, Illary Sbizzera, Gerard Stansby, David Torgerson, Peter Vowden, Laurie Williams, Robert Hinchliffe
BACKGROUND: Venous leg ulcers (VLUs) are the most common cause of leg ulceration, affecting 1 in 100 adults. VLUs may take many months to heal (25% fail to heal). Estimated prevalence is between 1% and 3% of the elderly population. Compression is the mainstay of treatment and few additional therapies exist to improve healing. Two previous trials have indicated that low-dose aspirin, as an adjunct to standard care, may improve healing time, but these trials were insufficiently robust. Aspirin is an inexpensive, widely used medication but its safety and efficacy in the treatment of VLUs remains to be established...
October 2018: Health Technology Assessment: HTA
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