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Medication therapy management

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https://www.readbyqxmd.com/read/29334488/severe-intraocular-pressure-elevation-after-intracameral-healon-5-viscoelastic-support-for-post-operative-hypotony-after-xen-gel-stent-insertion
#1
Alice Bruynseels, Freda Sii, Imran Masood, Peter Shah
PURPOSE: To describe (i) a novel case of severe intraocular pressure (IOP) elevation due to intracameral Healon 5 for management of early post-operative hypotony following XEN Gel Stent insertion and (ii) the management of this complication. METHODS: A case report. RESULTS: A 52-year-old male, with primary open angle glaucoma and suboptimal left IOP control on maximally tolerated medical therapy, was managed with XEN Gel Stent insertion at another tertiary eye unit...
January 12, 2018: Journal of Glaucoma
https://www.readbyqxmd.com/read/29334124/use-of-antiviral-medications-in-drug-reaction-with-eosinophilia-and-systemic-symptoms-dress-a-case-of-infantile-dress
#2
Maggie L Chow, David Kim, Sonia Kamath, David Peng, Minnelly Luu
A 3-month-old girl with Sturge-Weber syndrome presented with a morbilliform rash, eosinophilia, and fulminant liver failure to our tertiary pediatric hospital. She was diagnosed with drug reaction with eosinophilia and systemic symptoms complicated by viremia and evidence of viral hepatitis on liver biopsy. We discuss the role of viral reactivation in drug reaction with eosinophilia and systemic symptoms and the relevance of antiviral therapy in management.
January 15, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29333911/the-challenge-of-pediatric-uveitis-tertiary-referral-center-experience-in-the-united-states
#3
Mariantonia Ferrara, Laura Eggenschwiler, Andrew Stephenson, Alyssa Montieth, Nakhoul Nakhoul, Rafael Araùjo-Miranda, C Stephen Foster
PURPOSE: To describe the distribution, clinical findings, visual outcomes, treatment, and complications of children with uveitis at a tertiary referral ophthalmic center. METHODS: Retrospective cohort study. We reviewed the medical records of all patients ≤16 years with uveitis referred to Massachusetts Eye Research and Surgery Institution from March 2005 to July 2016. RESULTS: Of 286 included children, 62.24% were female. Mean age of onset was 8...
January 15, 2018: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/29333659/acute-renal-replacement-therapy-during-hospitalization-is-training-adequate
#4
Paul M Palevsky
Acute renal replacement therapy is one of the most common interventions provided by nephrologists, however, data on the quality of training provided to nephrology fellows is limited. Extensive curricula for acute renal replacement therapy and the management of poisonings and intoxications have been published, but personal experience suggests that there are significant opportunities to improve training. Particular areas to be considered include the use of novel technologies for assessment of volume status, greater emphasis on the dosing of medications during acute renal replacement therapy, greater training in assessing and tailoring treatment to the goals of care of the individual patient, incorporation of continuous quality improvement tools into the management of acute renal replacement therapy programs and development of robust simulation training to augment training...
January 14, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29333566/principles-of-management-of-central-nervous-system-infections
#5
REVIEW
Sunit Singhi, Suresh Kumar Angurana
CNS infections in children are medical emergency and are associated with high mortality and morbidity. For diagnosis, a high index of suspicion is required. Clinical assessment should be supplemented by laboratory investigations including CSF Gram stain and cultures, blood culture, PCR on CSF, serological tests, and imaging. Commonly associated life threatening complications include coma, seizure, raised intracranial pressure (ICP), focal deficits, shock, respiratory failure, and fluid and electrolyte abnormalities...
January 15, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29333461/extracorporeal-shock-wave-therapy-for-coronary-artery-disease-relationship-of-symptom-amelioration-and-ischemia-improvement
#6
Youko Takakuwa, Masayoshi Sarai, Hideki Kawai, Akira Yamada, Kenji Shiino, Kayoko Takada, Yasuomi Nagahara, Meiko Miyagi, Sadako Motoyama, Hiroshi Toyama, Yukio Ozaki
Objectives: The current management of coronary artery disease (CAD) relies on three major therapeutic options, namely medication, percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG). However, severe CAD that is not indicated for PCI or CABG still bears a poor prognosis due to the lack of effective treatments. In 2006, extracorporeal cardiac shock wave (SW) therapy reported on human for the first time. This treatment resulted in better myocardial perfusion as evaluated by dipyridamole stress thallium scintigraphy, angina symptoms, and exercise tolerance...
2018: Asia Oceania Journal of Nuclear Medicine & Biology
https://www.readbyqxmd.com/read/29332705/cutaneous-squamous-cell-carcinoma-management-of-advanced-and-high-stage-tumors
#7
REVIEW
Syril Keena T Que, Fiona O Zwald, Chrysalyne D Schmults
While the majority of cutaneous squamous cell carcinomas (cSCCs) can be treated surgically, the additional work-up and treatments indicated for high-risk cSCC remain undefined. In recent years, improvements in tumor staging systems have allowed for the more accurate stratification of tumors into high- and low-risk categories. This insight, along with the publication of cSCC guidelines, brings us closer to the development of a consensus approach. The second article in this continuing medical education series addresses in question and answer format the most common questions related to advanced and high-stage cSCCs, with a simplified flowchart...
February 2018: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29332231/stage-specific-therapeutic-strategies-of-medication-related-osteonecrosis-of-the-jaws-a-systematic-review-and-meta-analysis-of-the-drug-suspension-protocol
#8
REVIEW
Luca Ramaglia, Agostino Guida, Vincenzo Iorio-Siciliano, Alessandro Cuozzo, Andrea Blasi, Anton Sculean
OBJECTIVE: The most debated topic about medication-related osteonecrosis of the jaws (MRONJ) is its therapy, as there are no definitive guidelines. The aims of this systematic review were (a) to outline the best therapeutic approach according to the stage at diagnosis and (b) to perform a meta-analysis to assess whether the drug-holiday protocol may be or not an effective method in the management of MRONJ patients. MATERIALS AND METHODS: The systematic review was performed following the PRISMA principles...
January 13, 2018: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29332072/medical-management-of-movement-disorders
#9
Marina Picillo, Renato P Munhoz
Pharmacological treatment is the cornerstone in the management of movement disorders. Although most available treatment options have no impact on the underlying process of each movement disorder, symptomatic therapies can significantly improve patient's quality of life and level of disability. Here, we review the current knowledge on clinical symptomatic management of Parkinson's disease (both early and advanced stages), essential tremor, dystonia, and chorea. Ideally, treatment should be carried out by specialists with reasonable experience in movement disorders, as it needs to be tailored for each patient depending on several appraisals, including but not limited to patients' needs, compliance issues, potential side effects, caregiver support, and presence of comorbidities...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29331972/cohort-profile-the-comparative-outcomes-and-service-utilization-trends-coast-study-among-people-living-with-and-without-hiv-in-british-columbia-canada
#10
Oghenowede Eyawo, Mark W Hull, Kate Salters, Hasina Samji, Angela Cescon, Paul Sereda, Viviane D Lima, Bohdan Nosyk, David G T Whitehurst, Scott A Lear, Julio S G Montaner, Robert S Hogg
PURPOSE: The Comparative Outcomes And Service Utilization Trends (COAST) Study in British Columbia (BC), Canada, was designed to evaluate the determinants of health outcomes and health care services use among people living with HIV (PLHIV) as they age in the period following the introduction of combination antiretroviral therapy (cART). The study also assesses how age-associated comorbidities and health care use among PLHIV may differ from those observed in the general population. PARTICIPANTS: COAST was established through a data linkage between two provincial data sources: The BC Centre for Excellence in HIV/AIDS Drug Treatment Program, which centrally manages cART dispensation across BC and contains prospectively collected data on demographic, immunological, virological, cART use and other clinical information for all known PLHIV in BC; and Population Data BC, a provincial data repository that holds individual event-level, longitudinal data for all 4...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29331943/modern-management-of-perianal-fistulas-in-crohn-s-disease-future-directions
#11
REVIEW
Paulo Gustavo Kotze, Bo Shen, Amy Lightner, Takayuki Yamamoto, Antonino Spinelli, Subrata Ghosh, Remo Panaccione
Perianal fistulae in patients with Crohn's disease (CD) can be associated with significant morbidity resulting in negative impact on quality of life. The last two decades have seen significant advancements in the management of perianal fistulas in CD, which has evolved into a multidisciplinary approach that includes gastroenterologists, colorectal surgeons, endoscopists and radiologists. Despite the introduction of new medical therapies such as antitumour necrosis factor and novel models of care delivery, the best fistula healing rates reported with combined medical and surgical approaches are approximately 50%...
January 13, 2018: Gut
https://www.readbyqxmd.com/read/29330625/facilitating-adherence-to-endocrine-therapy-in-breast-cancer-stability-and-predictive-power-of-treatment-expectations-in-a-2-year-prospective-study
#12
Yiqi Pan, Sarah R Heisig, Pia von Blanckenburg, Ute-Susann Albert, Peyman Hadji, Winfried Rief, Yvonne Nestoriuc
PURPOSE: To identify modifiable factors predictive of long-term adherence to adjuvant endocrine therapy (AET). METHODS: As part of a 2-year cohort study in primary care (n = 116), we investigated whether initial treatment expectations predict adherence at 24 months after controlling for demographic, medical, and psychosocial variables. Treatment expectations were measured as necessity-concern beliefs, expected side-effect severity, and expected coping with side effects...
January 12, 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29330232/interventions-must-be-realistic-to-be-useful-and-completed-in-family-medicine
#13
EDITORIAL
Marjorie A Bowman, Dean A Seehusen, Anne Victoria Neale
Being realistic while helping our patients is this issue's theme. Given the volume of tasks required in family medicine, recommendations for improvements in direct care or care measurement cannot just be evidence-based but must also be realistic. On the list of realistic: ordering antipsychotics for symptoms of dementia in the elderly, despite recommendations to not do so; ordering antidepressants without fear that the patient could develop hypertension; mental health care providers in primary care offices; forced choice for opioid management; plus agenda setting for visit efficiency...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29329796/the-evolving-face-of-myocardial-reperfusion-in-acute-coronary-syndromes-a-primer-for-the-internist
#14
REVIEW
R Jay Widmer, Peter M Pollak, Malcolm R Bell, Bernard J Gersh, Nandan S Anavekar
Acute coronary syndromes (ACSs) account for a large proportion of disease burden in the United States and worldwide, and our understanding of ACS management continues to evolve. In this review we take a practical approach to evaluating and treating a patient with ACS, focusing on the optimal timing and methods of coronary reperfusion. Beginning with initial assessment and risk stratification, a provider managing the patient with ACS must be able to expeditiously decide on and implement the correct guideline-directed pathway to optimize outcomes...
January 9, 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29329694/management-of-refractory-vasodilatory-shock
#15
REVIEW
Jacob C Jentzer, Saraschandra Vallabhajosyula, Ashish K Khanna, Lakhmir S Chawla, Laurence W Busse, Kianoush B Kashani
Refractory shock is a lethal manifestation of cardiovascular failure defined by an inadequate hemodynamic response to high doses of vasopressor medications. Approximately 7% of critically ill patients will develop refractory shock, with short-term mortality exceeding 50%. Refractory vasodilatory shock develops from uncontrolled vasodilation and vascular hyporesponsiveness to endogenous vasoconstrictors, causing failure of physiologic vasoregulatory mechanisms. Standard approaches to initial management of shock include fluid resuscitation and initiation of norepinephrine...
January 9, 2018: Chest
https://www.readbyqxmd.com/read/29326401/efficacy-and-tolerability-of-trastuzumab-emtansine-in-advanced-human-epidermal-growth-factor-receptor-2-positive-breast-cancer
#16
W Yeo, M Y Luk, I S Soong, T Ys Yuen, T Y Ng, F Kf Mo, K Chan, S Y Wong, J Tsang, C Leung, J Js Suen, R Kc Ngan
INTRODUCTION: The management of human epidermal growth factor receptor 2 (HER2)-positive breast cancer has changed dramatically with the introduction and widespread use of HER2-targeted therapies. There is, however, relatively limited real-world information about the effectiveness and safety of trastuzumab emtansine (T-DM1) in the Hong Kong Chinese patients. We assessed the efficacy and toxicity profiles among local patients with HER2-positive advanced breast cancer who had received T-DM1 therapy in the second-line setting and beyond...
January 12, 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29326296/intrathecal-baclofen-therapy-versus-conventional-medical-management-for-severe-poststroke-spasticity-results-from-a-multicentre-randomised-controlled-open-label-trial-sisters
#17
Michael Creamer, Geoffrey Cloud, Peter Kossmehl, Michael Yochelson, Gerard E Francisco, Anthony B Ward, Jörg Wissel, Mauro Zampolini, Abdallah Abouihia, Nathalie Berthuy, Alessandra Calabrese, Meghann Loven, Leopold Saltuari
BACKGROUND: Intrathecal baclofen (ITB) is a treatment option for patients with severe poststroke spasticity (PSS) who have not reached their therapy goal with other interventions. METHODS: 'Spasticity In Stroke-Randomised Study' (SISTERS) was a randomised, controlled, open-label, multicentre phase IV study to evaluate the efficacy and safety of ITB therapy versus conventional medical management (CMM) with oral antispastic medications for treatment of PSS. Patients with chronic stroke with spasticity in ≥2 extremities and an Ashworth Scale (AS) score ≥3 in at least two affected muscle groups in the lower extremities (LE) were randomised (1:1) to ITB or CMM...
January 11, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29326146/prior-authorization-requirements-for-proprotein-convertase-subtilisin-kexin-type-9-inhibitors-across-us-private-and-public-payers
#18
Jalpa A Doshi, Justin T Puckett, Michael S Parmacek, Daniel J Rader
BACKGROUND: Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is) are an innovative treatment option for patients with familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease who require further lowering of low-density lipoprotein cholesterol. However, the high costs of these agents have spurred payers to implement utilization management policies to ensure appropriate use. We examined prior authorization (PA) requirements for PCSK9is across private and public US payers...
January 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29325481/stress-management-and-the-role-of-rhodiola-rosea-a-review
#19
Ion-George Anghelescu, David Edwards, Erich Seifritz, Siegfried Kasper
OBJECTIVE: Stress describes the physiological reaction to threat or pressure, which manifests as physical symptoms of exhaustion or energy loss and psychological symptoms, including irritability or tension. If untreated, chronic stress or burnout may develop, both are areas of unmet medical need. Evidence-based treatment and prevention measures are needed. METHODS: Prevention strategies and existing treatment options for stress-related symptoms were evaluated to establish criteria for an adequate pharmacological approach to stress...
January 11, 2018: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/29325305/-evaluation-of-asthma-management-from-the-surveys-in-30-provinces-of-china-in-2015-2016
#20
W Q Wang, J T Lin, X Zhou, C Z Wang, M Huang, S X Cai, P Chen, Q C Lin, J Y Zhou, Y H Gu, Y D Yuan, D J Sun, X H Yang, L Yang, J M Huo, Z C Chen, P Jiang, J Zhang, X W Ye, H G Liu, H P Tang, R Y Liu, C T Liu, W Zhang, C P Hu, Y Q Chen, X J Liu, L M Dai, W Zhou, Y J Huang, J Y Xu
Objective: To evaluate the general level of asthma management in urban areas of China and further promote the national asthma management plan. Methods: A multi-center, cross-sectional survey was carried out in 30 provinces of China (except for Tibet) during Oct 2015 to May 2016. It's a questionnaire-based face-to-face survey which included asthma management using peak flow meter (PFM) and pulmonary function test, medication choice of maintenance therapy and asthma education. Results: A total of 3 875 asthmatic outpatients were recruited including 2 347(60...
January 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
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