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https://www.readbyqxmd.com/read/28646558/neurology-concepts-young-women-and-ischemic-stroke-evaluation-and-management-in-the-emergency-department
#1
Bernard P Chang, Charles Wira, Joseph Miller, Murtaza Akhter, Bradley E Barth, Joshua Willey, Lauren Nentwich, Tracy Madsen
OBJECTIVE: Ischemic stroke is a leading cause of morbidity and mortality worldwide. While the incidence of ischemic stroke is highest in older populations, incidence of ischemic stroke in adults has been rising particularly rapidly among young (e.g. premenopausal) women. The evaluation and timely diagnosis of ischemic stroke in young women presents a challenging situation in the emergency department, due to a range of sex-specific risk factors and to broad differentials. The goals of this concepts paper are to summarize existing knowledge regarding the evaluation and management of young women with ischemic stroke in the acute setting...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28646556/injury-induced-maladaption-and-dysregulation-of-calcium-channel-alpha-2-delta-subunit-proteins-and-its-contribution-to-neuropathic-pain-development
#2
REVIEW
Nian Gong, John Park, Z David Luo
Voltage gated calcium channels (VGCCs) play important roles in physiological functions including modulations of neurotransmitter release, neuronal network activities, intracellular signaling pathways, and gene expression. Some pathological conditions, including nerve injuries, can cause dysregulation of VGCCs and their subunits. This in turn can lead to functional maladaption of VGCCs and their subunits, which can contribute to development of disorders such as pain sensations. This review summarized recent findings related to maladaptive changes of dysregulated VGCC alpha-2-delta-1 subunit (Cav α2 δ1 ) with a focus on exploration of mechanisms underlying contribution of Cav α2 δ1 to pain signal transduction...
June 23, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28646478/newborn-screening-for-fabry-disease-in-the-north-west-of-spain
#3
Cristobal Colon, Saida Ortolano, Cristina Melcon-Crespo, Jose V Alvarez, Olalla E Lopez-Suarez, Maria L Couce, José R Fernández-Lorenzo
Fabry disease is an X-linked lysosomal storage disorder caused by the impairment of α-galactosidase A. Enzyme replacement therapy is available to treat patients, who often experience delayed diagnosis. A newborn screening for Fabry disease was performed to study the prevalence of the pathology and to evaluate the possibility to implement the test in systematic screenings. We collected 14,600 dried blood spot samples (7575 males and 7025 females) and carried out a diagnostic study by fluorometric measurement of α-galactosidase A enzymatic activity and GLA gene sequencing...
June 23, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28646467/symptom-management-challenges-in-heart-failure-pharmacotherapy-considerations
#4
REVIEW
Diana Stewart, Mary Lynn McPherson
Heart failure is a chronic, progressive illness that is increasing in prevalence in the USA. Patients with advanced heart failure experience a high symptom burden that is comparable to patients with advanced cancer. Palliative care, however, is underutilized in patients with heart failure, and symptoms may go untreated as the disease progresses. A combination of pharmacologic and non-pharmacologic interventions should be used to address symptoms and maintain quality of life. While there have been significant advances in evidence-based heart failure treatments in recent years, selection of appropriate palliative medications as symptoms progress is challenging due to limited clinical studies in this patient population...
June 24, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28646442/variability-of-adverse-events-in-the-public-health-care-service-of-the-tuscany-region
#5
Sara Albolino, Riccardo Tartaglia, Tommaso Bellandi, Elisa Bianchini, Giancarlo Fabbro, Silvia Forni, Giulia Cernuschi, Annibale Biggeri
The objective of the study is to analyze the variation of adverse events (AEs) according to the different structure of hospitals. The study is a multicenter, retrospective study. It involves 4 teaching hospitals (THs) and 32 community hospitals, distributed in 12 local trusts (LTs), of the Tuscany Regional Healthcare Service (RHS). A random sample of the clinical records of patients admitted in LTs and THs in 2008 was selected from the database of the hospital discharge records of the centers. Among 11,293 clinical records included, a total of 354 adverse events were identified...
June 23, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28646359/music-as-an-adjunct-to-opioid-based-analgesia
#6
Peter R Chai, Stephanie Carreiro, Megan L Ranney, Ketki Karanam, Marko Ahtisaari, Robert Edwards, Kristin L Schreiber, Lubabah Ben-Ghaly, Timothy B Erickson, Edward W Boyer
Epidemic increases in opioid use in the USA and globally highlight the need for effective adjunctive therapies to opioid-based analgesia. Given the shortcomings of behavioral adjuncts to opioid-based pain treatment, an urgent need exists for pain-related behavioral interventions that resonate with broad patient populations, can be delivered confidentially in any environment, and can incorporate new content automatically. Understanding the potential for automated behavioral therapies like music therapy in modulating the experience of pain may unlock methods to transition patients to lower doses of pharmacologic therapy or provide alternatives to opioids during acute exacerbations of pain...
June 23, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28646082/subcutaneous-magnesium-in-the-advanced-cancer-setting
#7
Stephen J Fenning, Steinunn R Boyce, Paul Wilson, Fran Stretton
Hypomagnesaemia can arise from a variety of causes but is particularly prevalent in cancer populations. This case report describes a patient with recurrent symptomatic hypomagnesaemia, on the background of advanced ovarian cancer and a high-output ileostomy, who was successfully managed on a daily continuous subcutaneous infusion of magnesium via a syringe pump. There is limited published information on the subcutaneous administration of magnesium and, to our knowledge, this is the first case to report its routine delivery over 24 hours in a syringe pump...
June 23, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28646002/preparation-for-transition-to-adult-care-among-medicaid-insured-adolescents
#8
Gregory S Sawicki, Katharine C Garvey, Sara L Toomey, Kathryn A Williams, J Lee Hargraves, Thomas James, Jean L Raphael, Angelo P Giardino, Mark A Schuster, Jonathan A Finkelstein
BACKGROUND: Parents of children with chronic illness consistently report suboptimal preparation for transition from pediatric- to adult-focused health care. Little data are available on transition preparation for low-income youth in particular. METHODS: We conducted a mailed survey of youth with chronic illness enrolled in 2 large Medicaid health plans to determine the quality of transition preparation using the Adolescent Assessment of Preparation for Transition (ADAPT)...
June 23, 2017: Pediatrics
https://www.readbyqxmd.com/read/28645995/mepolizumab-for-the-treatment-of-severe-eosinophilic-asthma
#9
REVIEW
Mara N Poulakos, Shawna M Cargill, Melissa F Waineo, Allen L Wolford
PURPOSE: Published data on the pharmacology, pharmacokinetics and pharmacodynamics, and clinical efficacy and safety of the interleukin-5 antagonist mepolizumab are reviewed. SUMMARY: Asthma of the eosinophilic phenotype is characterized by persistent eosinophilic airway inflammation promoted primarily by T-helper type 2 cytokines, the key regulator of eosinophils. Patients with severe eosinophilic asthma are burdened by the need to administer high doses of corticosteroids to help manage their symptoms...
July 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28645976/a-combined-randomised-and-observational-study-of-surgery-for-fractures-in-the-distal-radius-in-the-elderly-crossfire-a-study-protocol
#10
Ian A Harris, Justine M Naylor, Andrew Lawson, Rachelle Buchbinder, Rebecca Ivers, Zsolt Balogh, Paul Smith, Rajat Mittal, Wei Xuan, Kirsten Howard, Arezoo Vafa, Piers Yates, Bertram Rieger, Geoff Smith, Ilia Elkinson, Woosung Kim, Mellick Chehade, Jai Sungaran, Kim Latendresse, James Wong, Sameer Viswanathan, Martin Richardson, Kush Shrestha, Herwig Drobetz, Phong Tran, Jeremy Loveridge, Richard Page, Raphael Hau, Roger Bingham, Jonathan Mulford, Ian Incoll
Fractures of the distal radius are common and occur in all age groups. The incidence is high in older populations due to osteoporosis and increased falls risk. Considerable practice variation exists in the management of distal radius fractures in older patients ranging from closed reduction with cast immobilisation to open reduction with plate fixation. Plating is currently the most common surgical treatment. While there is evidence showing no significant advantage for some forms of surgical fixation over conservative treatment, and no difference between different surgical techniques, there is a lack of evidence comparing two of the most common treatments used: closed reduction and casting versus plating...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645552/mortality-following-augmentation-cystoplasty-a-transitional-urologist-s-viewpoint
#11
REVIEW
D A Husmann
INTRODUCTION: Three complications have been hypothesized to increase patient mortality following enterocystoplasty: spontaneous bladder perforation, bladder neoplasia, and chronic renal failure (CRF). The present study examined risk of their occurrence and discussed ways to improve the quality of care. MATERIALS AND METHODS: The present transitional clinic followed 385 patients with a history of bladder augmentation using either ileal, sigmoid, or ascending colon...
June 3, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28645232/interplay-between-innate-immunity-and-the-plant-microbiota
#12
Stéphane Hacquard, Stijn Spaepen, Ruben Garrido-Oter, Paul Schulze-Lefert
The innate immune system of plants recognizes microbial pathogens and terminates their growth. However, recent findings suggest that at least one layer of this system is also engaged in cooperative plant-microbe interactions and influences host colonization by beneficial microbial communities. This immune layer involves sensing of microbe-associated molecular patterns (MAMPs) by pattern recognition receptors (PRRs) that initiate quantitative immune responses to control host-microbial load, whereas diversification of MAMPs and PRRs emerges as a mechanism that locally sculpts microbial assemblages in plant populations...
June 23, 2017: Annual Review of Phytopathology
https://www.readbyqxmd.com/read/28644930/trends-in-open-and-endoscopic-cubital-tunnel-release-in-the-medicare-patient-population
#13
Tsun Yee Law, Zachary S Hubbard, Lee Onn Chieng, Harvey W Chim
BACKGROUND: Cubital tunnel syndrome (CUT) is the second most common peripheral neuropathy with an annual incidence of 24.7 per 100 000, affecting nearly twice as many men as women. With increasing focus on cost-effectiveness and cost-containment in medicine, a critical understanding of utilization of health care resources for open and endoscopic approaches for cubital tunnel release is of value. The purpose of this study was to evaluate the costs and utilization trends of open and endoscopic cubital tunnel release...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644350/lack-of-knowledge-and-low-readiness-for-health-care-transition-in-eosinophilic-esophagitis-and-eosinophilic-gastroenteritis
#14
Swathi Eluri, Wendy M Book, Ellyn Kodroff, Mary Jo Strobel, Jessica H Gebhart, Patricia D Jones, Paul Menard-Katcher, Maria E Ferris, Evan S Dellon
OBJECTIVES: A growing population of adolescents/young adults with eosinophilic esophagitis (EoE) and eosinophilic gastroenteritis (EGE) will need to transition from pediatric to adult health providers. Measuring health care transition (HCT) readiness is critical, but no studies have evaluated this process in EoE/EGE. We determined the scope and predictors of HCT knowledge in patients and parents with EoE/EGE and measured HCT readiness in adolescents/young adults. METHODS: We conducted an online survey of patients 13 years or older and parents of patients with EoE/EGE who were diagnosed when 25 years or younger...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28644343/second-line-agents-in-pediatric-patients-with-autoimmune-hepatitis-a-systematic-review-and-meta-analysis
#15
Andréanne N Zizzo, Pamela L Valentino, Prakesh S Shah, Binita M Kamath
BACKGROUND AND AIMS: Ten percent to 20% of children with autoimmune hepatitis (AIH) require second-line therapy to achieve remission. Although current guidelines exist on first-line management, evidence for second-line therapy in treatment-refractory patients is lacking. Our aim was to perform a systematic review and meta-analysis of the efficacy and safety of second-line treatments used in this population. METHODS: Electronic and manual searches were used to identify potential studies for inclusion...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28644300/breathlessness-in-the-primary-care-setting
#16
Noel Baxter
PURPOSE OF REVIEW: Breathlessness is a high-volume problem with 10% of adults experiencing the symptom daily placing a heavy burden on the health and wider economy. As it worsens, they enter the specialist and hospital-based symptom services where costs quickly escalate and people may find themselves in a place not of their choosing. For many, their care will be delivered by a disease or organ specialist and can find themselves passing between physicians without coordination for symptom support...
July 20, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28644187/perioperative-blood-management-in-pediatric-spine-surgery
#17
Matthew E Oetgen, Jody Litrenta
Blood management strategies are integral to successful outcomes in many types of orthopaedic surgery. These strategies minimize blood loss and transfusion requirements, ultimately decreasing complications, improving outcomes, and potentially eliminating risks associated with allogeneic transfusion. Practices to achieve these goals include preoperative evaluation and optimization of hemoglobin, the use of pharmacologic agents or anesthetic methods, intraoperative techniques to improve hemostasis and cell salvage, and the use of predonated autologous blood...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28644185/a-simple-ultrasound-score-for-the-accurate-detection-of-inflammatory-activity-in-crohn-s-disease
#18
Kerri L Novak, Gilaad G Kaplan, Remo Panaccione, Elnaz Ehteshami Afshar, Divine Tanyingoh, Mark Swain, Amelia Kellar, Stephanie Wilson
BACKGROUND: Ultrasound is accurate in the detection of Crohn's disease. Our aim was to identify ultrasound parameters contributing to inflammatory disease activity, develop a simple score, and validate this score prospectively. METHODS: This study comprised 2 single-center investigations. The first was a retrospective study on a population that had received colonoscopies (as a gold-standard diagnostic) within 60 days of ultrasound. The second was a prospective study on 2 populations: patients requiring induction with adalimumab and patients on adalimumab maintenance therapy...
June 20, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28644182/incidence-and-management-of-recurrence-in-patients-with-crohn-s-disease-who-have-undergone-intestinal-resection-the-practicrohn-study
#19
Eugeni Domènech, Valle Garcia, Marisa Iborra, Ana Gutiérrez, Santiago García-López, María D Martín Arranz, Esther Garcia-Planella, Marta Calvo, Luisa Castro, Miguel Mínguez, Carlos Taxonera, Berta Juliá, Luis Cea-Calvo, Cristina Romero, Manuel Barreiro-de Acosta
BACKGROUND: More than 50% of patients with Crohn's disease require intestinal resection at least once. Postoperative recurrence (POR) is almost uniform if prophylactic treatment is not started early. Endoscopic monitoring is generally advised. We studied the incidence and management of recurrence in patients who had undergone intestinal resection. METHODS: Practicrohn was an observational retrospective study performed in 26 Spanish hospitals including patients aged ≥18 years who underwent Crohn's disease-related ileocolonic resection between January 2007 and December 2010...
June 20, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28644154/acute-promyelocytic-leukemia-and-chronic-lymphocytic-leukemia-concomitant-presentation-of-two-molecularly-distinct-entities
#20
Jingdong Su, Diana Veillon, Rodney Shackelford, James Cotelingam, Hazem El-Osta, Glenn Mills, Reinhold Munker, Srinivas Devarakonda
Acute myeloid leukemia (AML) developing in patients with chronic lymphocytic leukemia (CLL) is very uncommon and usually associated with prior treatment. Acute promyelocytic leukemia (APL) accounts for a very small proportion of treatment-associated AML. So far, there has been only one reported case of APL occurring post radiation for prostate cancer in a patient with CLL. We report herein the first case of APL and CLL presenting concomitantly in an untreated patient. Evaluation of peripheral blood and bone marrow aspirate with immunohistochemistry, flow cytometry, and FISH to confirm two morphologically, molecularly and genetically distinct leukemic populations characteristic of APL and CLL is required...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
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