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https://www.readbyqxmd.com/read/28329583/dermatologic-care-of-the-transgender-patient
#1
Timothy Hermosura Almazan, Filamer D Kabigting
Literature is limited regarding the medical and cosmetic dermatologic issues pertinent to transgender patients and the reasons why 19 transgender individuals seek care from dermatologists. Clinical management of this population has historically been limited to 20 mental health providers, endocrinologists, and select surgeons with expertise in sex reassignment surgery. The impact of hormonal 21 therapy on transgender skin has been well documented in endocrinology journals, but is underrepresented in dermatology 22 literature...
October 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28328662/surgical-management-of-hidradenitis-suppurativa-a-14-year-retrospective-review-of-98-consecutive-patients
#2
Kathleen S Romanowski, Alice Fagin, Bridget Werling, Gretchen Kass, Junlin Liao, Thomas Granchi, Gerald P Kealey, Lucy Wibbenmeyer
Hidradenitis suppurativa (HS) is a debilitating suppurative disease of the apocrine/follicular glands. Medical treatment has some efficacy in early-stage disease but is costly and requires frequent physician visits. Advanced disease usually requires surgical intervention. This treatment has not been well described in the literature. We sought to review our experience with HS treatment in a large surgical cohort. A retrospective review of 98 consecutive HS patients from 2000 to 2014 was performed. A two-stage operative approach was used...
March 15, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28328650/exosomes-in-critical-illness
#3
Nora Terrasini, Vincenzo Lionetti
OBJECTIVE: Exosomes are small, cell-released vesicles (40-100 nm in size) with the potential to transfer proteins, lipids, small RNAs, messenger RNAs, or DNA between cells via interstitial fluids. Due to their role in tissue homeostasis, exosomes have emerged as a new type of therapeutic and diagnostic (theranostic) tool in the noninvasive assessment of organ response to injury or treatment and in the development of reliable organ-protective intensive therapy. Our review provides current insights into the role of exosomes in the personalized management of injury and repair responses in critical illness...
March 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28328578/sustained-improvements-in-pain-mood-function-and-opioid-use-post-interdisciplinary-pain-rehabilitation-in-patients-weaned-from-high-and-low-dose-chronic-opioid-therapy
#4
Kelly L Huffman, Taylor E Rush, Youran Fan, Giries W Sweis, Brinder Vij, Edward C Covington, Judith Scheman, Manu Mathews
Increased prescribing of opioids for chronic non cancer pain is associated with significant social costs, including overdose and addiction. In this context, there is interest in interdisciplinary chronic pain rehabilitation programs (ICPRP) focusing on self-management and minimizing opioid use. This study examined outcomes of patients weaned from opioids in an ICPRP from 2007-2012. Participants included 413 patients on high dose (HD) chronic opioid therapy (COT; >100mg), 528 on low dose (LD) COT and 516 not on opioids (NO)...
March 21, 2017: Pain
https://www.readbyqxmd.com/read/28327969/circulating-tumour-dna-predicts-response-to-anti-pd1-antibodies-in-metastatic-melanoma
#5
J H Lee, G V Long, S Boyd, S Lo, A M Menzies, V Tembe, A Guminski, V Jakrot, R A Scolyer, G J Mann, R F Kefford, M S Carlino, H Rizos
Background: Programmed death 1 (PD1) inhibitors are now a foundation of medical management of metastatic melanoma. This study sought to determine whether circulating tumour DNA (ctDNA) provides useful early response and prognostic information. Patients and methods: We evaluated the relationship between pre-treatment and early on treatment ctDNA and outcome in melanoma patients treated with PD1 inhibitors alone or in combination with ipilimumab. Results: ctDNA was detected in 40/76 patients (53%) at baseline, and correlated with stage, LDH levels, disease volume and ECOG performance...
January 24, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28327875/compliance-with-the-prescription-of-antihypertensive-medications-and-blood-pressure-control-in-primary-care
#6
Mayra Faria Novello, Maria Luiza Garcia Rosa, Ranier Tagarro Ferreira, Icaro Gusmão Nunes, Antonio José Lagoeiro Jorge, Dayse Mary da Silva Correia, Wolney de Andrade Martins, Evandro Tinoco Mesquita
Background: Hypertension is the most prevalent risk factor for cardiovascular disease, and its proper control can prevent the high morbidity and mortality associated with this disease. Objective: To assess the degree of compliance of antihypertensive prescriptions with the VI Brazilian Guidelines on Hypertension and the blood pressure control rate in primary care. Methods: Cross-sectional study conducted between August 2011 and November 2012, including 332 adults ≥ 45 years registered in the Family Doctor Program in Niteroi and selected randomly...
February 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28327480/pharmacotherapy-of-patients-with-stable-bronchial-asthma
#7
REVIEW
Ashutosh Nath Aggarwal
Several reliever and controller medications are available for managing patients with stable asthma. Inhaled corticosteroids (ICS) are the mainstay of treatment, and can be combined with long-acting beta-agonists (LABA) for patients with moderate or severe disease. An ICS-LABA combination is best administered as a single inhaler used for both maintenance and emergency use. A stepwise approach to therapy has recently been proposed as part of Indian guidelines for management of asthma. Clinicians should advise proper use of inhaled medications, and step up or step down treatment based on adequacy of asthma control...
November 2016: National Medical Journal of India
https://www.readbyqxmd.com/read/28326906/a-practical-guide-to-the-sublingual-immunotherapy-tablet-adverse-event-profile-implications-for-clinical-practice
#8
David I Bernstein, Jose A Bardelas, Bodil Svanholm Fogh, Amarjot Kaur, Ziliang Li, Hendrik Nolte
OBJECTIVES: Treatment with allergy immunotherapy improves allergic rhinoconjunctivitis, but can also improve comorbidities associated with allergic rhinitis such as asthma. Sublingual immunotherapy (SLIT)-tablets are a convenient and efficacious method of allergy immunotherapy. They are self-administered after the first tablet has been provided under medical supervision. Therapy may elicit local reactions or, rarely, systemic allergic reactions. The objective of this report is to inform healthcare practitioners about the safety and tolerability profile of SLIT-tablets and use this information to provide practical guidance that may inform patients regarding potential adverse reactions and how to manage them...
March 22, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28326470/targeted-treatment-of-brain-metastases
#9
REVIEW
Nicole Shonka, Vyshak Alva Venur, Manmeet S Ahluwalia
PURPOSE OF REVIEW: Brain metastases are the most common intracranial tumors in adults. Historically, the median survival after the diagnosis of brain metastases has been dismal and medical therapies had a limited role in the management of these patients. RECENT FINDINGS: The advent of targeted therapy has ushered in an era of increased hope for patients with brain metastases. The most common malignancies that result in brain metastases-melanoma, lung cancer, and breast cancer, often have actionable mutations, which make them good candidates for targeted systemic therapy...
April 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28325604/early-prediction-of-radiotherapy-induced-parotid-shrinkage-and-toxicity-based-on-ct-radiomics-and-fuzzy-classification
#10
Marco Pota, Elisa Scalco, Giuseppe Sanguineti, Alessia Farneti, Giovanni Mauro Cattaneo, Giovanna Rizzo, Massimo Esposito
MOTIVATION: Patients under radiotherapy for head-and-neck cancer often suffer of long-term xerostomia, and/or consistent shrinkage of parotid glands. In order to avoid these drawbacks, adaptive therapy can be planned for patients at risk, if the prediction is obtained timely, before or during the early phase of treatment. Artificial intelligence can address the problem, by learning from examples and building classification models. In particular, fuzzy logic has shown its suitability for medical applications, in order to manage uncertain data, and to build transparent rule-based classifiers...
March 18, 2017: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/28325588/operative-management-of-chronic-pancreatitis-a-review
#11
REVIEW
John D Tillou, Jacob A Tatum, Joshua S Jolissaint, Daniel S Strand, Andrew Y Wang, Victor Zaydfudim, Reid B Adams, Kenneth L Brayman
BACKGROUND: Pain secondary to chronic pancreatitis is a difficult clinical problem to manage. Many patients are treated medically or undergo endoscopic therapy and surgical intervention is often reserved for those who have failed to gain adequate pain relief from a more conservative approach. RESULTS: There have been a number of advances in the operative management of chronic pancreatitis over the last few decades and current therapies include drainage procedures (pancreaticojejunostomy, etc...
March 14, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28325560/long-term-prognosis-of-childhood-absence-epilepsy
#12
C Martínez-Ferrández, E Martínez-Salcedo, C Casas-Fernández, H Alarcón-Martínez, S Ibáñez-Micó, R Domingo-Jiménez
INTRODUCTION: Childhood absence epilepsy (CAE) is considered easily manageable with medication provided that a strict patient classification system is employed. It accounts for 10% of all childhood epilepsy cases starting before the age of 15 and it is most frequent in school-aged girls. The aim of this study is to analyse long-term outcomes of patients diagnosed with CAE according to the Loiseau and Panayiotopoulos criteria and treated during childhood. METHODS: We conducted a retrospective study including 69 patients with CAE who are currently older than 11; data were gathered from medical histories, EEG records, and telephone questionnaires...
March 18, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28325240/cancer-care-access-and-outcomes-for-american-indian-populations-in-the-united-states-challenges-and-models-for-progress
#13
REVIEW
B Ashleigh Guadagnolo, Daniel G Petereit, C Norman Coleman
Low socioeconomic and health care access realities of being American Indian/Alaskan Native (AI/AN) in the United States combined with decades of data documenting poor cancer outcomes for this population provide a population nested within the United States that is analogous to the cancer care landscape of low- and middle-income countries internationally. We reviewed the medical literature with respect to cancer prevention, access to cancer treatment, and access to effective supportive and palliative care for AI/AN populations in the United States...
April 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28324867/blood-glucose-levels-and-glycaemic-burden-in-76-341-patients-attending-primary-care-bittersweet-findings-from-a-9-year-cohort-study
#14
Melinda J Carrington, Neale Cohen, Joshua F Wiley
AIMS: Diabetes care is principally applied in the primary care setting whereby we examined trends in glycaemic levels and goals and estimated avoidable glycaemic burden. METHODS: We retrieved glycated haemoglobin (HbA1C) results and glucose-lowering prescription records from a patient-based medical database during 2005-2013. There were 275,480 available HbA1C measurements from 76,341 individuals managed by 960 general practitioners from 321 clinics across Australia...
February 27, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28324302/huntington-s-disease-update-on-treatments
#15
REVIEW
Kara J Wyant, Andrew J Ridder, Praveen Dayalu
Huntington's disease (HD) is an autosomal dominantly inherited neurodegenerative disease characterized by progressive motor, behavioral, and cognitive decline, ending in death. Despite the discovery of the underlying genetic mutation more than 20 years ago, treatment remains focused on symptomatic management. Chorea, the most recognizable symptom, responds to medication that reduces dopaminergic neurotransmission. Psychiatric symptoms such as depression and anxiety may also respond well to symptomatic therapies...
April 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28324047/functional-imaging-in-the-follow-up-of-enteropancreatic-neuroendocrine-tumors-clinical-usefulness-and-indications
#16
Elettra Merola, Marianne E Pavel, Francesco Panzuto, Gabriele Capurso, Noemi Cicchese, Anja Rinke, Thomas M Gress, Elsa Iannicelli, Daniela Prosperi, Patrizia Pizzichini, Vikas Prasad, Patrizia Kump, Rainer Lipp, Stefano Partelli, Massimo Falconi, Bertram Wiedenmann, Gianfranco Delle Fave
Context: Functional imaging tests (FITs) detecting somatostatin receptors expression (i.e., Somatostatin Receptor Scintigraphy, 68Ga-DOTA-peptide positron emission tomography/computed tomography) have a pivotal role in the diagnosis of neuroendocrine tumors (NETs), while their indication during follow-up still needs to be clarified. Objective: Investigate the role of FITs after diagnosis of metastatic enteropancreatic NETs, identifying patients who might benefit from these exams...
January 13, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28323662/hvad-flow-waveform-morphologies-theoretical-foundation-and-implications-for-clinical-practice
#17
Jonathan D Rich, Daniel Burkhoff
Continuous flow ventricular assist device (cfVAD) performance and patient hemodynamic conditions are intimately interrelated and dynamic, changing frequently with alterations in physiologic conditions, particularly pre- and after-loading conditions. The Heartware cfVAD (HVAD) provides a unique feature among currently approved VADs of providing an estimated instantaneous flow waveform, the characteristics of which can provide significant insights into patient and device properties. Despite being readily available, HVAD waveforms are poorly understood, underutilized and insufficiently leveraged, even by clinicians who regularly manage HVAD patients...
March 16, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28323276/open-capsule-budesonide-for-refractory-celiac-disease
#18
Saurabh S Mukewar, Ayush Sharma, Alberto Rubio-Tapia, Tsung-Teh Wu, Bana Jabri, Joseph A Murray
OBJECTIVES: Refractory celiac disease (RCD) is a rare condition often associated with poor prognosis. Various immunosuppressive medications (IMs) have been used with modest success. We describe outcomes in patients treated with open-capsule budesonide (OB), including those for whom IM treatment failed. METHODS: We identified RCD patients treated with OB at Mayo Clinic, Rochester, Minnesota from 2003 to 2015. Demographic, serologic, and clinical variables were analyzed...
March 21, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28323195/left-ventricular-assist-device-related-infections-a-multicentric-study
#19
S Siméon, E Flécher, M Revest, M Niculescu, J-C Roussel, M Michel, P Leprince, P Tattevin
OBJECTIVES: Implantable left ventricular assist device (LVAD) is a major therapeutic progress for end-stage heart failure in selected patients. As their use is expanding, infectious complications are emerging, with limited data available to guide their management. We aimed to better characterize LVAD-related infections. METHODS: We enrolled all consecutive patients diagnosed with LVAD-related infections in 3 referral centers in France, using standardized definition of infections in patients with LVAD...
March 18, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28321243/cardiac-drug-therapy-considerations-in-the-elderly
#20
REVIEW
Mohamed Ayan, Naga Venkata Pothineni, Aisha Siraj, Jawahar L Mehta
Elderly individuals constitute a majority of patients encountered in current cardiovascular clinical practice. Management of these patients is a clinical challenge owing to a multitude of factors. Although medications such as statins have been shown to reduce cardiovascular mortality in the general population, evidence supporting the use of these drugs in patients greater than 75 years of age is sparse. Furthermore, aging associated changes in organ function and associated comorbidities influence the pharmacokinetics of multiple medications and can potentiate drug toxicity...
December 2016: Journal of Geriatric Cardiology: JGC
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