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https://www.readbyqxmd.com/read/29236352/iccs-escca-consensus-guidelines-for-the-clinical-utility-of-testing-for-gpi-anchor-deficient-clones-in-paroxysmal-nocturnal-hemoglobinuria-pnh-and-other-bone-marrow-disorders-part-1
#1
Amy E Dezern, Michael J Borowitz
Paroxysmal nocturnal hemoglobinuria (PNH) arises as a consequence of the non-malignant clonal expansion of one or more hematopoietic stem cells with an acquired somatic mutation of the PIGA gene.(1) Progeny of affected stem cells are deficient in glycosyl phosphatidylinositol-anchored proteins (GPI-APs). This deficiency is readily detected by flow cytometry. Though this seems straightforward, the clinical utility of this testing requires that the ordering clinician understand not only the characteristics of the test, but also the biology of the underlying disease, and the clinical and laboratory manifestations in the individual patient...
December 13, 2017: Cytometry. Part B, Clinical Cytometry
https://www.readbyqxmd.com/read/29236347/the-full-blood-count-as-an-ancillary-test-to-support-the-diagnosis-of-giant-cell-arteritis
#2
Lawrence J Oh, Eugene Wong, Juliana Andrici, Peter McCluskey, James E H Smith, Anthony J Gill
BACKGROUND: Temporal artery biopsy is considered the investigation of choice to definitively diagnose giant cell arteritis in patients with compatible symptoms. However it is invasive and not completely sensitive. Serum markers, particularly ESR, can be supportive but are not definitive in individual cases. AIMS: We sought to investigate whether indices derived from the full blood count including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), were associated with a positive biopsy in patients with suspected giant cell arteritis...
December 13, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29236339/physical-activity-level-among-children-recovering-from-severe-acute-malnutrition
#3
Esther Babirekere-Iriso, Maren Johanne Heilskov Rytter, Hanifa Namusoke, Ezekiel Mupere, Kim F Michaelsen, Søren Brage, Ken D Stark, Lotte Lauritzen, André Briend, Henrik Friis, Daniel Faurholt-Jepsen
OBJECTIVE: To assess the level and predictors of physical activity at discharge among children recovering from severe acute malnutrition (SAM). METHODS: We conducted a prospective study among 69 children 6 - 59 months of age admitted with SAM for nutritional rehabilitation at Mulago National Referral Hospital, Uganda. Using hip-mounted tri-axial accelerometers, we measured physical activity expressed as counts per minute (cpm) during the last three days of hospital treatment...
December 13, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29236338/inflammatory-cytokine-and-c-reactive-protein-concentrations-in-dogs-with-systemic-inflammatory-response-syndrome
#4
Kris Gommeren, Isabelle Desmas, Alexandra Garcia, Natalie Bauer, Andreas Moritz, Joachim Roth, Dominique Peeters
OBJECTIVE: To evaluate C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α) kinetics in dogs with a systemic inflammatory response syndrome (SIRS) presented to an emergency service. We hypothesized serum CRP concentrations would increase and vary during hospitalization, and would correlate with plasma IL-6 and TNF-α concentrations, vary in magnitude according to the underlying disease, and predict survival. DESIGN: Prospective, observational, clinical study...
December 13, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/29236332/a-new-mechanism-for-%C3%AE-lactamases-class-d-enzymes-degrade-1%C3%AE-methyl-carbapenems-via-lactone-formation
#5
Christopher T Lohans, Emma van Groesen, Kiran Kumar, Catherine L Tooke, James Spencer, Robert S Paton, Jürgen Brem, Christopher Schofield
β-Lactamases threaten the clinical use of carbapenems, considered antibiotics of last resort. The classical mechanism of serine carbapenemase activity proceeds via hydrolysis of an acyl-enzyme intermediate. We show that class D β-lactamases also degrade clinically used 1β-methyl-substituted carbapenems via the unprecedented formation of a carbapenem-derived β-lactone. β-Lactone formation results from the nucleophilic attack of the carbapenem hydroxyethyl side chain onto the ester carbonyl of the acyl-enzyme intermediate...
December 13, 2017: Angewandte Chemie
https://www.readbyqxmd.com/read/29236303/impact-of-antimicrobial-stewardship-program-on-hospitalized-patients-at-the-intensive-care-unit-a-prospective-audit-and-feedback-study
#6
Maher R Khdour, Hussein O Hallak, Mamoon Al-Deyab, Mowafq A Nasif, Aliaa M Khalili, Ahamad A Dallashi, Mohammad B Khofash, Michael G Scott
AIMS: Inappropriate use of antibiotics is one of the most important factors contributing to the emergence of drug resistant pathogens. The purpose of this study was to measure the clinical impact of Antimicrobial Stewardship Program (ASP) interventions on hospitalized patients at the Intensive care unit at Palestinian Medical Complex. METHODS: A prospective audit with intervention and feedback by ASP team within 48-72h of antibiotic administration began in Sep, 2015...
December 13, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29236294/acute-myeloid-leukemia-and-myelodysplastic-syndrome-after-adjuvant-chemotherapy-a-population-based-study-among-older-breast-cancer-patients
#7
Aron S Rosenstock, Jiangong Niu, Sharon H Giordano, Hui Zhao, Antonio C Wolff, Mariana Chavez-MacGregor
BACKGROUND: Chemotherapy for early breast cancer is associated with a small risk of developing myelodysplastic syndrome (MDS) and/or acute myeloid leukemia (AML). The aim of this study was to determine the risk of developing AML or MDS after modern adjuvant chemotherapy in older breast cancer patients and to further define the risk of individual chemotherapy regimens. METHODS: Patients diagnosed with stage I to III breast cancer from 2003 to 2009 were identified in the Surveillance, Epidemiology, and End Results-Medicare and Texas Cancer Registry-Medicare linked databases...
December 13, 2017: Cancer
https://www.readbyqxmd.com/read/29236286/corticosteroids-for-pneumonia
#8
REVIEW
Anat Stern, Keren Skalsky, Tomer Avni, Elena Carrara, Leonard Leibovici, Mical Paul
BACKGROUND: Pneumonia is a common and potentially serious illness. Corticosteroids have been suggested for the treatment of different types of infection, however their role in the treatment of pneumonia remains unclear. This is an update of a review published in 2011. OBJECTIVES: To assess the efficacy and safety of corticosteroids in the treatment of pneumonia. SEARCH METHODS: We searched the Cochrane Acute Respiratory Infections Group's Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS on 3 March 2017, together with relevant conference proceedings and references of identified trials...
December 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29236231/dimethyl-fumarate-a-review-in-moderate-to-severe-plaque-psoriasis
#9
Hannah A Blair
Fumaric acid esters (FAEs) have been used in the treatment of psoriasis in some European countries for over 20 years, and are recommended in the European guidelines for the management of moderate to severe plaque psoriasis. Dimethyl fumarate (Skilarence®; hereafter referred to as DMF) is an orally administered FAE indicated for the treatment of moderate to severe plaque psoriasis in adults in need of systemic medicinal therapy; unlike other available FAEs, it is not formulated in combination with monoethyl fumarate salts...
December 13, 2017: Drugs
https://www.readbyqxmd.com/read/29236229/model-based-therapeutic-drug-monitoring-of-infliximab-using-a-single-serum-trough-concentration
#10
David Ternant, Christophe Passot, Alexandre Aubourg, Philippe Goupille, Céline Desvignes, Laurence Picon, Thierry Lecomte, Denis Mulleman, Gilles Paintaud
BACKGROUND AND OBJECTIVES: The pharmacokinetics of infliximab are highly variable and influence clinical response in chronic inflammatory diseases. The goal of this study was to build a Bayesian model allowing predictions of upcoming infliximab concentrations and dosing regimen adjustment, using only one concentration measurement and information regarding the last infliximab infusion. METHODS: This retrospective study was based on data from 218 patients treated with infliximab in Tours University Hospital who were randomly assigned to learning (two-thirds) or validation (one-third) data subsets...
December 13, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/29236222/an-indirect-comparison-of-changes-in-the-impact-of-weight-on-quality-of-life-among-subjects-with-type-2-diabetes-treated-with-antihyperglycemic-agents-in-dual-therapy-with-metformin
#11
Shana B Traina, April Slee, Suzy Van Sanden, Joris Diels
INTRODUCTION: It is important to capture the patient experience with a diabetes treatment in clinical trials; however, use of instruments to assess patient-reported outcomes (PROs) in diabetes trials is inconsistent and results may not be reported alongside primary efficacy data. In lieu of head-to-head data, indirect comparisons can be used to compare competing interventions. In this study, we used indirect comparison methods to assess differences in PRO score changes between canagliflozin and other antihyperglycemic agents as add-on to metformin...
December 13, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29236198/sdf-1-induces-tnf-mediated-apoptosis-in-cardiac-myocytes
#12
Andrew A Jarrah, Martina Schwarskopf, Edward R Wang, Thomas LaRocca, Ashwini Dhume, Shihong Zhang, Lahouria Hadri, Roger J Hajjar, Alison D Schecter, Sima T Tarzami
Chemokines are small secreted proteins with chemoattractant properties that play a key role in inflammation. One such chemokine, Stromal cell-derived factor-1 (SDF-1) also known as CXCL12, and its receptor, CXCR4, are expressed and functional in cardiac myocytes. SDF-1 both stimulates and enhances the cellular signal which attracts potentially beneficial stem cells for tissue repair within the ischemic heart. Paradoxically however, this chemokine is known to act in concert with the inflammatory cytokines of the innate immune response which contributes to cellular injury through the recruitment of inflammatory cells during ischemia...
December 13, 2017: Apoptosis: An International Journal on Programmed Cell Death
https://www.readbyqxmd.com/read/29236186/establishment-of-pathological-quantitative-method-for-determining-undifferentiated-component-ratio-in-patients-with-differentiated-undifferentiated-mixed-type-early-gastric-cancer-and-clinical-significance-of-this-ratio
#13
Hirohisa Takeuchi, Nobutsugu Abe, Yoshikazu Hashimoto, Atsuko Ooki, Gen Nagao, Kazuhiko Hirano, Yasuo Ookura, Tadahiko Masaki, Toshiyuki Mori, Masanori Sugiyama
PURPOSES: The purpose of this study was to establish a pathological quantitative method for determining the undifferentiated components ratio (UCR) in patients with differentiated/undifferentiated mixed-type (Mixed-type) early gastric cancer (EGC) and to examine the clinical significance. METHODS: The subjects were 410 patients who underwent surgical resection for EGC with the invasion limited to m or sm1. Analysis 1: In 12 randomly selected patients with Mixed-type cancer, we calculated the area ratio and the ratio of the length ratio using ImageJ and analyzed the correlation between them...
December 13, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/29236147/-platelet-inhibition-in-elderly-patients
#14
A Schäfer, J Bauersachs
Single antiplatelet therapy (SAPT) using predominantly acetylsalicylic acid (ASA) is the baseline anti-thrombotic therapy in primary as well as secondary prevention of atherosclerotic disease. Dual antiplatelet therapy (DAPT) is the cornerstone of maintenance medication following elective percutaneous coronary interventions or acute coronary syndromes (ST elevation myocardial infarction, non-ST elevation myocardial infarction and unstable angina pectoris). In the past the duration of DAPT in particular has been frequently discussed...
December 13, 2017: Herz
https://www.readbyqxmd.com/read/29236093/trends-in-troponin-only-testing-for-ami-in-academic-teaching-hospitals-and-the-impact-of-choosing-wisely%C3%A2
#15
Micah T Prochaska, Samuel F Hohmann, Matthew Modes, Vineet M Arora
BACKGROUND: Identifying hospitals that are both early and consistent adopters of high-value care can help shed light on the culture and practices at those institutions that are necessary to promote high-value care nationwide. The use of troponin to diagnose acute myocardial infarction (AMI), and not to test for myoglobin or creatine kinase-MB (CK-MB), is a high-value recommendation of the Choosing Wisely® campaign. OBJECTIVE: To examine the variation in cardiac biomarker testing and the effect of the Choosing Wisely® troponin-only recommendation for the diagnosis of AMI...
December 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29236091/noncoding-copy-number-variations-are-associated-with-congenital-limb-malformation
#16
Ricarda Flöttmann, Bjørt K Kragesteen, Sinje Geuer, Magdalena Socha, Lila Allou, Anna Sowińska-Seidler, Laure Bosquillon de Jarcy, Johannes Wagner, Aleksander Jamsheer, Barbara Oehl-Jaschkowitz, Lars Wittler, Deepthi de Silva, Ingo Kurth, Idit Maya, Fernando Santos-Simarro, Wiebke Hülsemann, Eva Klopocki, Roger Mountford, Alan Fryer, Guntram Borck, Denise Horn, Pablo Lapunzina, Meredith Wilson, Bénédicte Mascrez, Denis Duboule, Stefan Mundlos, Malte Spielmann
PurposeCopy-number variants (CNVs) are generally interpreted by linking the effects of gene dosage with phenotypes. The clinical interpretation of noncoding CNVs remains challenging. We investigated the percentage of disease-associated CNVs in patients with congenital limb malformations that affect noncoding cis-regulatory sequences versus genes sensitive to gene dosage effects.MethodsWe applied high-resolution copy-number analysis to 340 unrelated individuals with isolated limb malformation. To investigate novel candidate CNVs, we re-engineered human CNVs in mice using clustered regularly interspaced short palindromic repeats (CRISPR)-based genome editing...
October 12, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29236081/pharmacogenomics-guided-personalization-of-warfarin-and-tamoxifen
#17
REVIEW
Theodore J Wigle, Laura E Jansen, Wendy A Teft, Richard B Kim
The use of pharmacogenomics to personalize drug therapy has been a long-sought goal for warfarin and tamoxifen. However, conflicting evidence has created reason for hesitation in recommending pharmacogenomics-guided care for both drugs. This review will provide a summary of the evidence to date on the association between cytochrome P450 enzymes and the clinical end points of warfarin and tamoxifen therapy. Further, highlighting the clinical experiences that we have gained over the past ten years of running a personalized medicine program, we will offer our perspectives on the utility and the limitations of pharmacogenomics-guided care for warfarin and tamoxifen therapy...
December 13, 2017: Journal of Personalized Medicine
https://www.readbyqxmd.com/read/29236062/measuring-activity-performance-of-older-adults-using-the-activpal-a-rapid-review
#18
REVIEW
Charice S Chan, Susan E Slaughter, C Allyson Jones, Carla Ickert, Adrian S Wagg
Current measures of physical activity and sedentary behaviors such as questionnaires and functional assessments are insufficient to provide comprehensive data on older adults. In response, the use of activity monitors has increased. The purpose of this review was to summarize and assess the quality of observational literature on activity measuring of older adults using the activPAL activity monitor. Seventeen databases and a bibliography, compiled by the activPAL creators, were searched. Articles were included if they were in English, were peer-reviewed, included people 65 years or older, measured activity using the activPAL and reported at least one of the following outcomes: step count, hours upright, hours sitting/lying, hours stepping, or hours standing...
December 13, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29236060/the-use-of-poly-d-l-lactic-acid-pdlla-devices-for-bone-augmentation-techniques-a-systematic-review
#19
REVIEW
Marco Annunziata, Livia Nastri, Gennaro Cecoro, Luigi Guida
Poly-d,l-lactic acid (PDLLA) has been proposed in dentistry for regenerative procedures in the form of membranes, screws, and pins. The aim of this review was to evaluate the efficacy of bone augmentation techniques using PDLLA devices. A literature search was carried out by two independent and calibrated reviewers. All interventional and observational studies assessing the efficacy of bone augmentation techniques using PDLLA devices were included. Six studies were included. The relevant variability of design and methods impeded any qualitative or quantitative comparison...
December 13, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/29236052/micrornas-in-parkinson-s-disease-from-pathogenesis-to-novel-diagnostic-and-therapeutic-approaches
#20
REVIEW
Loredana Leggio, Silvia Vivarelli, Francesca L'Episcopo, Cataldo Tirolo, Salvo Caniglia, Nunzio Testa, Bianca Marchetti, Nunzio Iraci
Parkinson's disease (PD) is the most prevalent central nervous system (CNS) movement disorder and the second most common neurodegenerative disease overall. PD is characterized by the progressive loss of dopaminergic (DAergic) neurons in the substantia nigra pars compacta (SNpc) within the midbrain, accumulation of alpha-synuclein (α-SYN) in Lewy bodies and neurites and excessive neuroinflammation. The neurodegenerative processes typically begin decades before the appearance of clinical symptoms. Therefore, the diagnosis is achievable only when the majority of the relevant DAergic neurons have already died and for that reason available treatments are only palliative at best...
December 13, 2017: International Journal of Molecular Sciences
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