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https://www.readbyqxmd.com/read/28636298/-renal-toxicities-in-oncology-therapies
#1
Bruno Rodrigues, Sandro Anchisi, Pierre-Auguste Petignat, Niels Gobin
Development of oncological treatments has progressively and significantly reduced both mortality and morbidity. Chemotherapy and more recently immunotherapy may have short- and long-term side effects among which, renal involvement is one of the most frequent complications, which may alter therapeutic options and quality of life. High cumulative doses of chemotherapy, concomitant administration of nephrotoxic treatment and pre-existing nephropathy are to be carefully considered. This article intends to review some practical considerations concerning therapies from a nephrological point of view...
May 17, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28636269/commentary-on-r-d-trends-away-from-general-medicine-cardiovascular-drugs-can-the-fda-help-reverse-the-trend
#2
R J Meyer
In the latter part of the 20th century, drug development in cardiovascular diseases (CVDs) was a paragon of "modern" therapeutics, bringing about a substantial number of effective, well-tolerated agents targeting some of the most prevalent diseases of the Western world. These drugs were often examples of rational drug development targeting specific pathophysiologic pathways previously elucidated through basic research (e.g., targeting of the renin-angiotensin system or the cholesterol synthesis pathway). The widespread adoption of these ground-breaking medications in practice and into medical guidelines undoubtedly played a role in the fall of morbidity and mortality from CVD in the United States in recent decades...
June 21, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28636191/-fast-track-development-and-approval-process-for-heart-failure-therapeutics
#3
L Papadimitriou, J Butler
Heart failure (HF) is a global epidemic, with a high mortality and morbidity burden. In such diseases, earlier access to lifesaving therapeutic regimens is imperative, and could be accomplished by improving the drug development and approval process, without jeopardizing patient safety. The US Food and Drug Administration (FDA) has already established mechanisms facilitating the latter, but further guidance to enhance and expedite the process holds promise to further improve patient outcomes.
June 21, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28636084/co-morbidities-and-bleeding-in-elderly-patients-with-haemophilia-a-survey-of-the-german-austrian-and-swiss-society-of-thrombosis-and-haemostasis-research-gth
#4
W Miesbach, S-E Reitter-Pfoertner, R Klamroth, F Langer, H-H Wolf, A Tiede, B Siegmund, U Scholz, P R Müller, H Eichler, I Pabinger
BACKGROUND: Nowadays patients with haemophilia survive longer due to improvements in haemophilia care. It has been hypothesized that the bleeding type and frequency may vary with age and are influenced by co-morbidities and co-medication in elderly patients. OBJECTIVES: To investigate a large group of patients older than 60 years of age with haemophilia concerning haemophilia treatment, bleeding pattern changes, co-morbidities, co-medication, bleeding sites and patient mortality...
June 21, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28634771/off-pump-versus-on-pump-coronary-surgery-in-patients-with-chronic-kidney-disease-a-meta-analysis
#5
Yushu Wang, Sui Zhu, Peijuan Gao, Juteng Zhou, Qing Zhang
BACKGROUND: Patients with chronic kidney disease (CKD) have worse adverse cardiovascular outcomes after coronary artery bypass grafting (CABG). However, the adverse cardiovascular outcomes between off-pump coronary artery bypass grafting (OPCAB) versus on-pump coronary artery bypass grafting (ONCAB) in these patients have been a subject of debate. METHODS: We undertook a comprehensive literature search of PubMed, Embase, and the Cochrane Library database to identify all relevant studies comparing techniques between OPCAB and ONCAB in CKD patients...
June 20, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28634627/influence-of-multiple-stapler-firings-used-for-rectal-division-on-colorectal-anastomotic-leak-rate
#6
Tamara Braunschmid, Nikolaus Hartig, Lukas Baumann, Bernhard Dauser, Friedrich Herbst
BACKGROUND: Anastomotic leakage following colorectal resection remains one of the most significant complications with relevant morbidity and mortality. There is evidence that a higher number of stapler firings for rectal division can affect the leak rate in double stapling anastomosis. However, there are no data concerning compression anastomosis. We present our institutional experience addressing this issue. DESIGN: This is a retrospective review of a prospective institutional database of patients undergoing colonic and rectal resection for benign and malignant indications between January 2008 and December 2014 at the surgical department of the St...
June 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28634578/neonatal-venous-thromboembolism
#7
REVIEW
Kristina M Haley
Neonates are the pediatric population at highest risk for development of venous thromboembolism (VTE), and the incidence of VTE in the neonatal population is increasing. This is especially true in the critically ill population. Several large studies indicate that the incidence of neonatal VTE is up almost threefold in the last two decades. Central lines, fluid fluctuations, sepsis, liver dysfunction, and inflammation contribute to the risk profile for VTE development in ill neonates. In addition, the neonatal hemostatic system is different from that of older children and adults...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28634526/concurrent-babesiosis-and-serological-evidence-of-lyme-disease-in-a-young-patient
#8
Mark Adler, Thein Swe, Akari Thein Naing
Human babesiosis co-infected with Lyme disease in a young patient is an important condition. Here, we describe a case of a 39-year-old male patient with concurrent babesiosis and Lyme disease. Co-infections of tick borne diseases are often difficult to diagnose and underreported, and resulting in significant morbidity and mortality to patients. While co-infections have been infrequently described, it is of paramount importance that clinicians should be able to diagnose early and treat them effectively according to the patient geographical area and history of tick bite...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28634525/pseudomembranous-aspergillar-tracheobronchitis-in-a-non-neutropenic-critically-ill-patient-in-the-intensive-care-unit
#9
Sameen Khalid, Fnu Asad-Ur -Rahman, Aamer Abbass, Sigfredo Aldarondo, Khalid Abusaada
Invasive aspergillosis is an important cause of morbidity and mortality among immunocompromised patients. Prolonged neutropenia is the most common risk factor. It has rarely been reported to occur in non-neutropenic critically ill patients in the intensive care unit setting. Mortality rate in this group has been reported to be as high as 92%. We report a case of tracheobronchial aspergillosis in a non-neutropenic critically ill patient to highlight the fact that critically ill patients admitted in the intensive care unit can develop opportunistic infections such as invasive aspergillosis even in the absence of classic risk factors and prior history of immunosuppression...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28634522/popliteal-arterial-thrombosis-in-nephrotic-syndrome-a-case-report
#10
Niranjan Tachamo, Rashmi Dhital, Bidhya Timilsina, Salik Nazir, Saroj Lohani, Dilli Ram Poudel
Thrombosis is a frequent cause of morbidity and mortality in patients with nephrotic syndrome (NS). Though venous thromboses are common in NS, arterial thromboses are relatively rare. Commonly involved arteries include coronary, iliac, femoral, renal, cerebral, pulmonary, mesenteric, and axillary arteries, and the aorta. Arterial thromboses are associated with poor prognosis; treatment options are limited and patients may not always be amenable to treatment. We present the case of a 39-year-old female with NS who presented with thigh pain and was found to have sub-acute popliteal artery thrombosis...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28634519/prevalence-and-risk-factors-of-heart-failure-in-the-usa-nhanes-2013-2014-epidemiological-follow-up-study
#11
Saketram Komanduri, Yogesh Jadhao, Sai S Guduru, Pramil Cheriyath, Yijin Wert
Background: Heart Failure (HF) is a progressive epidemic associated with considerable morbidity and mortality. Self-reported data from the National Health and Nutrition Examination Survey (NHANES) provides a unique representation of individuals suffering from HF. The purpose of this study is to analyze updated NHANES 2013-2014 data to identify any changes in the prevalence and current risk factors of HF, especially given the novel lifestyles and increased medical awareness of current generations. Methods: NHANES uses a multistage probability sampling design under the Centers for Disease Control and Prevention (CDC)...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28634363/long-term-health-outcomes-in-patients-with-prader-willi-syndrome-a-nationwide-cohort-study-in-denmark
#12
E Hedgeman, S P Ulrichsen, S Carter, N C Kreher, K P Malobisky, M M Braun, J Fryzek, M S Olsen
BACKGROUND: Prader-Willi syndrome (PWS) is a rare congenital disease that affects growth, sexual development, cognitive function and behavior. Individuals exhibit food preoccupation and hyperphagia, which may lead to obesity with premature morbidity and mortality. The aim of this work was to evaluate the risk of venous thromboembolisms (VTE), myocardial infarction, pulmonary hypertension, sleep apnea, depression, anxiety and all-cause mortality among persons with PWS as compared to an age- and sex-matched general population cohort...
June 21, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28634324/ficolins-do-not-alter-host-immune-responses-to-lipopolysaccharide-induced-inflammation-in-vivo
#13
Ninette Genster, Olga Østrup, Camilla Schjalm, Tom Eirik Mollnes, Jack B Cowland, Peter Garred
Ficolins are a family of pattern recognition molecules that are capable of activating the lectin pathway of complement. A limited number of reports have demonstrated a protective role of ficolins in animal models of infection. In addition, an immune modulatory role of ficolins has been suggested. Yet, the contribution of ficolins to inflammatory disease processes remains elusive. To address this, we investigated ficolin deficient mice during a lipopolysaccharide (LPS)-induced model of systemic inflammation...
June 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28634280/surgical-clipping-or-endovascular-coiling-for-unruptured-intracranial-aneurysms-a-pragmatic-randomised-trial
#14
Tim E Darsaut, J Max Findlay, Elsa Magro, Marc Kotowski, Daniel Roy, Alain Weill, Michel W Bojanowski, Chiraz Chaalala, Daniela Iancu, Howard Lesiuk, John Sinclair, Felix Scholtes, Didier Martin, Michael M Chow, Cian J O'Kelly, John H Wong, Ken Butcher, Allan J Fox, Adam S Arthur, Francois Guilbert, Lu Tian, Miguel Chagnon, Suzanne Nolet, Guylaine Gevry, Jean Raymond
BACKGROUND: Unruptured intracranial aneurysms (UIAs) are increasingly diagnosed and are commonly treated using endovascular treatment or microsurgical clipping. The safety and efficacy of treatments have not been compared in a randomised trial. How to treat patients with UIAs suitable for both options remains unknown. METHODS: We randomly allocated clipping or coiling to patients with one or more 3-25 mm UIAs judged treatable both ways. The primary outcome was treatment failure, defined as: initial failure of aneurysm treatment, intracranial haemorrhage or residual aneurysm on 1-year imaging...
June 20, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28634267/30-years-of-the-mineralocorticoid-receptor-the-role-of-the-mineralocorticoid-receptor-in-the-vasculature
#15
REVIEW
Jennifer J DuPont, Iris Z Jaffe
Since the mineralocorticoid receptor (MR) was cloned 30 years ago, it has become clear that MR is expressed in extra-renal tissues, including the cardiovascular system, where it is expressed in all cells of the vasculature. Understanding the role of MR in the vasculature has been of particular interest as clinical trials show that MR antagonism improves cardiovascular outcomes out of proportion to changes in blood pressure. The last 30 years of research have demonstrated that MR is a functional hormone-activated transcription factor in vascular smooth muscle cells and endothelial cells...
July 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/28634174/prognostic-value-of-uric-acid-for-pulmonary-thromboembolism
#16
Savas Ozsu, Arif M Çoşar, Hayriye Bektas Aksoy, Yilmaz Bülbül, Funda Oztuna, S Caner Karahan, Tevfik Ozlu
BACKGROUND: Pulmonary thromboembolism is a serious cardiovascular condition with considerable morbidity and mortality. Clinical studies have indicated that hyperuricemia is an independent risk factor for cardiovascular events. The aim of this study was to investigate possible value of the serum levels of uric acid (UA) in predicting 30-d pulmonary thromboembolism-related mortality. METHODS: Pulmonary thromboembolism was confirmed by computed tomography pulmonary angiography, demographic data, troponin, systolic pressure and pulse on admission, and simplified pulmonary embolism severity index assessment...
June 20, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28634102/depression-and-asthma-outcomes-in-older-adults-results-from-the-national-health-and-nutrition-examination-survey
#17
Pooja O Patel, Minal R Patel, Alan P Baptist
BACKGROUND: Older adults have high rates of asthma morbidity and mortality, as well as increased rates of depression. There are no nationally representative studies describing the association of depression on key asthma outcomes such as emergency department (ED) visits among older adults. OBJECTIVE: The objective of this study was to determine the association of depression with asthma outcomes in older adults (age ≥ 55) from the National Health and Nutrition Examination Survey (NHANES)...
June 17, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28634094/regional-anesthesia-in-total-joint-arthroplasty-what-is-the-evidence
#18
Dalia H Elmofty, Asokumar Buvanendran
Total joint arthroplasty is one of the most common surgical procedures performed for end-stage osteoarthritis. The increasing demand for knee and hip arthroplasties along with the improvement in life expectancy has created a substantial medical and economic impact on the society. Effective planning of health care for these individuals is vital. The best method for providing anesthesia and analgesia for total joint arthroplasty has not been defined. Yet, emerging evidence suggests that the type of anesthesia can affect morbidity and mortality of patients undergoing these procedures...
May 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28634051/revisiting-interdialytic-weight-gain-and-mortality-association-with-serum-albumin-interactions-the-japanese-dialysis-outcomes-and-practice-pattern-study
#19
Noriaki Kurita, Yasuaki Hayashino, Shin Yamazaki, Tadao Akizawa, Takashi Akiba, Akira Saito, Shunichi Fukuhara
BACKGROUND: The dialysis practice guideline in Japan sets a limit on the allowed interdialytic weight gain (IDWG) <6%. However, the effects of relative gain of fluid volume to body weight may differ in presence of morbid conditions. Here, we examined whether or not the associations between IDWG and mortality differ by serum albumin (sAlb), a nutritional and illness marker. DESIGN: The study type used was prospective cohort study. SUBJECTS: Patients who participated in the Japan Dialysis Outcomes and Practice Pattern Study (phase 1-4 [1999-2011]) and received thrice-weekly hemodialysis...
June 17, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28633906/respiratory-syncytial-virus-rsv-in-adult-emergency-department-patients-do-emergency-providers-consider-rsv-as-an-admission-diagnosis-a-retrospective-observational-study-carried-out-at-massachusetts-general-hospital-boston-ma
#20
William Binder, Jill Thorsen, Pierre Borczuk
BACKGROUND: Respiratory Syncytial Virus (RSV) has been recognized for over half a century as a cause of morbidity in infants and children. Over the past 20years, data has emerged linking RSV as a cause of illness in adults resulting in 177,000 annual hospitalizations and up to 14,000 deaths among older adults. OBJECTIVE: Characterize clinical variables in a cohort of adult RSV patients. We hypothesize that emergency physicians do not routinely consider RSV in the differential diagnosis (DDx) of influenza like illness...
June 11, 2017: American Journal of Emergency Medicine
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