Read by QxMD icon Read

Clinical approach

Chie Kudo-Saito, Akiko Ishida, Yuji Shouya, Koji Teramoto, Tomoyuki Igarashi, Ryoko Kon, Kenji Saito, Chihiro Awada, Yamato Ogiwara, Masayoshi Toyoura
Immune dysfunction is a strong factor in the resistance of cancer to treatment. Blocking immune checkpoint pathways is a promising approach to improve anti-tumor immunity, but the clinical efficacies are still limited. We previously identified follistatin-like 1 (FSTL1) as a determinant of immune dysfunction mediated by mesenchymal stromal/stem cells (MSCs) and immunoregulatory cells. Here, we demonstrate that blocking FSTL1 but not immune checkpoint pathways significantly suppresses cancer progression and metastasis in several mouse tumor models with increased MSCs...
August 14, 2018: Cell Reports
Antti Lindgren, Mervyn DI Vergouwen, Irene van der Schaaf, Ale Algra, Marieke Wermer, Mike J Clarke, Gabriel Je Rinkel
BACKGROUND: Around 30% of people who are admitted to hospital with aneurysmal subarachnoid haemorrhage (SAH) will rebleed in the initial month after the haemorrhage if the aneurysm is not treated. The two most commonly used methods to occlude the aneurysm for prevention of rebleeding are microsurgical clipping of the neck of the aneurysm and occlusion of the lumen of the aneurysm by means of endovascular coiling. This is an update of a systematic review that was previously published in 2005...
August 15, 2018: Cochrane Database of Systematic Reviews
Peter Ssebutinde, Imelda T Kyamwanga, Eleanor Turyakira, Stephen Asiimwe, Francis Bajunirwe
BACKGROUND: The prevalence of HIV infection among older persons is increasing yet older age at initiation of antiretroviral therapy (ART) may be associated with poorer treatment outcomes including mortality. However, majority of these studies have been done in the western world and there is limited data in resource limited settings. Our study used routinely collected health facility data to assess trends in age at initiation of ART, the effect of age at ART initiation on mortality and immunological response at a large urban hospital in south western Uganda...
2018: PloS One
Theresa S Yang, David W Hsia, Dong W Chang
PURPOSE: Readmission after hospitalization for malignant pleural effusion (MPE) may represent gaps in the quality of health care delivery. The goal of this study was to determine the frequency of 30-day readmission for MPE and identify clinical factors associated with rehospitalization. PATIENTS AND METHODS: A retrospective cohort of adults hospitalized for MPE from 2009 to 2011 was analyzed using an administrative database. The primary outcome was all-cause 30-day readmission rate...
August 15, 2018: Journal of Oncology Practice
Hualong Fu, Zhen Chen, Lee Josephson, Zijing Li, Steven H Liang
Ionotropic glutamate receptors (iGluRs) are ligand-gated ion channels that mediate excitatory neurotransmission within the mammalian central nervous system. iGluRs exist as three main groups: N-methyl-D-aspartate (NMDA), α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) and kainate receptors. The past decades have witnessed a remarkable development of PET tracers targeting different iGluRs including NMDA and AMPA receptors, and several of the tracers have advanced to clinical imaging studies. Here, we assess the recent development of iGluR PET probes, focusing on tracer design, brain kinetics, and performance in PET imaging studies...
August 15, 2018: Journal of Medicinal Chemistry
Joel Cameron Balmer, Christopher G Pretty, Shaun Davidson, Thomas Desaive, Shun Kamoi, Antoine Pironet, Philippe Morimont, Nathalie Janssen, Bernard Lambermont, Geoffrey M Shaw, J Geoffrey Chase

 Pulse wave velocity measurements are an indicator of arterial stiffness and possible cardiovascular dysfunction. It is usually calculated by measuring the pulse transit time (PTT) over a known distance through the arteries. In animal studies, reliable PTT measures can be obtained using two pressure catheters. However, such direct, invasive methods are undesirable in clinical settings. A less invasive alternative measure of PTT is pulse arrival time (PAT), the time between the Q-wave of an electrocardiogram (ECG) and the arrival of the foot of the beats pressure waveform at one pressure catheter...
August 15, 2018: Physiological Measurement
Alen Agaronov, Tayla Ash, Martina Sepulveda, Elsie M Taveras, Kirsten K Davison
Sleep promotion in childhood may reduce the risk of obesity, but little is known of its inclusion in family-based interventions. This study examines the proportion and context of family-based interventions to prevent childhood obesity that promote child sleep. We drew on data from a recent systematic review and content analysis of family-based interventions for childhood obesity prevention published between 2008 and 2015, coupled with new data on sleep promotion strategies, designs, and measures. Out of 119 eligible family-based interventions to prevent childhood obesity, 24 (20%) promoted child sleep...
August 15, 2018: Childhood Obesity
Kristine Laws, Kogularamanan Suntharalingam
Cancer stem cells (CSCs) are heavily linked to fatal incidences of cancer relapse and metastasis. Conventional cancer therapies such as surgery, chemotherapy, and radiation are largely futile against CSCs. Therefore, highly original approaches are needed to overcome CSCs and provide durable, long-term clinical outcomes. Many academia- and pharmaceutical-led studies aimed at developing chemical or biological anti-CSC agents are ongoing, however, the application of inorganic compounds is rare. In this minireview we discuss how the chemical diversity and versatility offered by metals has been harnessed to develop an unprecedented, emerging class of metallopharmaceuticals; CSC-active inorganics...
August 15, 2018: Chembiochem: a European Journal of Chemical Biology
Heinz Katschnig
As a clinician, I can easily agree with the author that a person's own reality of being healthy is independent of physical evidence or clinical categories and that this perspective should be considered to improve clinical care. However, I cannot follow the assumptions about the nature and working of modern medicine and psychiatry as typically using "black box" and one-size-fits-all treatments in daily practice. I outline several working contexts of doctors where this criticism does only marginally apply or not at all and wonder whether the author might wish, if possible at all from a philosophical viewpoint, to differentiate her concepts with regard to these different contexts...
August 15, 2018: Journal of Evaluation in Clinical Practice
N C Stefanis, V Mavreas, Ι Νimatoudis, F Gourzis, Μ Sarakouri, A Vgontzas, A Douzenis
The disorders of the psychosis spectrum, with the most severe being schizophrenia, are prevalent and have a great impact on the patients' quality of life. The purpose of this article is to highlight the need for a novel national strategic approach to the management of psychotic disorders in accordance with the international principles of early intervention. Even though outpatient treatment is considered adequate, there is an urgent need to adopt an early and more comprehensive and effective intervention strategy for young patients with psychosis and their families whose clinical and personal needs are clearly not met by the existing infrastructure of our mental health services...
April 2018: Psychiatrikē, Psychiatriki
Sajal Jain, Harpal S Buttar, Meena Chintameneni, Ginpreet Kaur
BACKGROUND: Inflammation-induced endothelial abnormalities, dietary habits, and tobacco smoking are considered to be the primary risk factors for causing atherosclerosis and cardiovascular diseases (CVDs), including coronary heart disease (CHD), cerebrovascular disorders, peripheral arterial disease, rheumatic heart disease, congenital heart defects, deep vein thrombosis and pulmonary embolism. Prevention of CVDs with anti-inflammatory and anti-oxidant agents has been a challenging task for decades...
August 15, 2018: Recent Patents on Inflammation & Allergy Drug Discovery
Kristin H Jarman, Natalie C Heller, Sarah C Jenson, Janine R Hutchinson, Brooke L Deatherage Kaiser, Samuel H Payne, David S Wunschel, Eric D Merkley
Bottom-up proteomics is increasingly being used to characterize unknown environmental, clinical and forensic samples. Proteomics-based bacterial identification typically proceeds by tabulating peptide "hits" (i.e. confidently identified peptides) associated with the organisms in a database; those organisms with enough hits are declared present in the sample. This approach has proven successful in laboratory studies, however, important research gaps remain. First, the common-practice reliance on unique peptides for identification is susceptible to a phenomenon known as signal erosion...
August 15, 2018: Journal of Proteome Research
Peter C Wyer
For over 30 years, "evidence-based" clinical guidelines remained entrenched in an oversimplified, design-based, framework for rating the strength of evidence supporting clinical recommendations. The approach frequently equated the rating of evidence with that of the recommendations themselves. "Grading Recommendations Assessment, Development and Evaluation (GRADE)" has emerged as a proposed antidote to obsolete guideline methodology. GRADE sponsors and collaborators are in the process of attempting to amplify and extend the framework to encompass implementation and adaptation of guidelines, above and beyond the evaluation and rating of clinical research...
August 15, 2018: Journal of Evaluation in Clinical Practice
Mònica Castellà-Creus, Pilar DELGado-Hito, Isabel Andrés-Martínez, Maria-Eulàlia Juvé-Udina
AIM: To understand the individualization process of the standardized care plan that nurses design for hospitalized patients. BACKGROUND: To apply the nursing process, it is advisable to use standardized care plans to standardize the diagnosis, planning and assessment stages. However, the fundamental element of this methodology is the individualization of the care plan. DESIGN: A qualitative study, framed within the constructivist paradigm and applying the Grounded Theory method, in accordance with Strauss and Corbin's approach...
August 14, 2018: Journal of Advanced Nursing
Sarah C W S E Franco de Oliveira, Alexandre D Zucoloto, Carolina D R de Oliveira, Edna M M Hernandez, Ligia V G Fruchtengarten, Tiago F de Oliveira, Mauricio Yonamine
This work describes a simple approach to overcome challenges in emergency toxicological analysis, using liquid-liquid extraction and high-performance liquid chromatography coupled with a diode-array detector (HPLC-DAD). A rapid procedure has been developed, for the extraction and detection of 19 analytes from the following drug classes: analgesics, benzodiazepines, antidepressants, anticonvulsants and drugs of abuse. These substances are relevant in the context of emergency toxicology in Brazil. The method has been validated according to international guidelines by establishing parameters such as lower limit of quantification, sensitivity, linearity, accuracy and precision...
August 14, 2018: Biomedical Chromatography: BMC
Bryan Lutman, Jamie Bloom, Brandon Nussenblatt, Victor Romo
PURPOSE OF REVIEW: This article discusses the etiology and management of post-craniotomy headache and pain. A review of available as well as investigatory treatment modalities is offered, followed by suggestions for optimal management of post-craniotomy headache. RECENT FINDINGS: There is a dearth of evidence-based practice regarding the differential diagnosis, natural history, and management of post-craniotomy headache. The etiology of post-craniotomy headache is typically multifactorial, with patients' medical history, type of craniotomy, and perioperative management all playing a role...
August 14, 2018: Current Pain and Headache Reports
Bao Yang, Chenlong Yang, Yilin Sun, Jiang Du, Pinan Liu, Guijun Jia, Wang Jia, Yazhuo Zhang, Jisheng Wang, Yulun Xu, Shuo Wang
BACKGROUND: Mixed gangliocytoma-pituitary adenoma is an extremely rare tumor occurring in the sellar region, histologically composed of both gangliocytic and pituitary adenomatous architectures. The histogenesis of these tumors remains unknown, and the diagnosis, treatment, and prognosis are yet to be fully understood. METHODS: We retrospectively reviewed the clinical, radiological, and histopathological profiles from a series of 20 patients with sellar mixed gangliocytoma-pituitary adenomas...
August 14, 2018: Acta Neurochirurgica
Diamantis I Tsilimigras, Amir A Rahnemai-Azar, Ioannis Ntanasis-Stathopoulos, Maria Gavriatopoulou, Demetrios Moris, Eleftherios Spartalis, Jordan M Cloyd, Sharon M Weber, Timothy M Pawlik
INTRODUCTION: Hepatic adenomas (HAs) are a benign and relatively rare type of liver neoplasms. We review the diagnosis, evaluation, and potential therapeutic management options for patients with HA. METHODS: A comprehensive review of the English literature was performed utilizing MEDLINE/PubMed and Web of Science databases with end of search date the 30th April of 2018. In PubMed, the terms "hepatocellular," "hepatic," "liver," and "adenoma," "adenomatosis" were searched in the title and/or abstract...
August 14, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Patricia H Birch, S Adam, R R Coe, A V Port, M Vortel, J M Friedman, F Légaré
Shared decision-making (SDM) is a collaborative approach in which clinicians educate, support, and guide patients as they make informed, value-congruent decisions. SDM improves patients' health-related outcomes through increasing knowledge, reducing decisional conflict, and enhancing experience of care. We measured SDM in genetic counselling appointments with 27 pregnant women who were at increased risk to have a baby with a genetic abnormality. The eight experienced genetic counsellors who participated had no specific SDM training and were unaware that SDM was being assessed...
August 14, 2018: Journal of Genetic Counseling
Rory M Shallis, Mina L Xu, Nikolai A Podoltsev, Susanna A Curtis, Bryden T Considine, Suchin R Khanna, Alexa J Siddon, Amer M Zeidan
In patients suspected to have myelodysplastic syndrome (MDS), especially in those patients without cytogenetic abnormalities or blast excess, accurate morphologic review by an expert hematopathologist and meticulous exclusion of other secondary causes of myelodysplasia are vital to establish the diagnosis. Errors in diagnosis can lead to dangerous consequences such as the administration of hypomethylating agents, lenalidomide, or even the use of intensive chemotherapy or allogeneic hematopoietic cell transplantation in patients who do not have an underlying MDS or even a malignant hematopoietic process...
August 14, 2018: Annals of Hematology
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"