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Conservative therapy

Elodie Alessandri-Gradt, Fabienne De Oliveira, Marie Leoz, Véronique Lemee, David L Robertson, Felix Feyertag, Paul-Alain Ngoupo, Philippe Mauclere, François Simon, Jean-Christophe Plantier
OBJECTIVES: HIV/1 group P (HIV-1/P) is the last HIV/1 group discovered and to date, comprises only two strains. To obtain new insights into this divergent group, we screened for new infections by developing specific tools, and analysed phenotypic and genotypic properties of the prototypic strain RBF168. In addition, the follow-up of the unique patient monitored so far, has raised the knowledge of the natural history of this infection and its therapeutic management. DESIGN/METHODS: We developed an HIV-1/P specific sero-molecular strategy and screened over 29,498 specimen samples...
March 15, 2018: AIDS
Christina H Stuelten, Carole A Parent, Denise J Montell
Metastasis remains the greatest challenge in the clinical management of cancer. Cell motility is a fundamental and ancient cellular behaviour that contributes to metastasis and is conserved in simple organisms. In this Review, we evaluate insights relevant to human cancer that are derived from the study of cell motility in non-mammalian model organisms. Dictyostelium discoideum, Caenorhabditis elegans, Drosophila melanogaster and Danio rerio permit direct observation of cells moving in complex native environments and lend themselves to large-scale genetic and pharmacological screening...
March 16, 2018: Nature Reviews. Cancer
Paolo Calabrò, Felice Gragnano, Marco di Maio, Giuseppe Patti, Emilia Antonucci, Plinio Cirillo, Paolo Gresele, Gualtiero Palareti, Vittorio Pengo, Pasquale Pignatelli, Mauro Pennacchi, Antonino Granatelli, Stefano De Servi, Leonardo De Luca, Rossella Marcucci
The epidemiology and management of patients with acute coronary syndromes (ACSs) have evolved. We aimed to describe recent demographics and therapeutic changes in the Italian ACS population. We analyzed data from 2 multicenter consecutive Italian registries (the EYESHOT [EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalised in iTalian cardiac care units] and START-ANTIPLATELET registries) enrolling patients with ACS between December 2013 and June 2016. An overall population of 3756 patients with ACS was enrolled: 2585 in the EYESHOT and 1171 in the START-ANTIPLATELET...
January 1, 2018: Angiology
Amanda N Seddon, Joshua Chaim, Oguz Akin, Esther Drill, Angela G Michael, Nelly Adel, Martin S Tallman
BACKGROUND: The current standard of care for the treatment of patients with newly diagnosed acute myeloid leukemia (AML) is an anthracycline plus cytarabine. Both anthracyclines and cytarabine have been associated with the development of typhlitis, a serious adverse event characterized by inflammation of the bowel wall in patients with profound neutropenia, diagnosed by abdominal CT imaging and clinical symptoms. Given the paucity of available data, the aim of our study was to determine the incidence of typhlitis among AML patients receiving induction chemotherapy with idarubicin 12 mg/m2 (IDA), daunorubicin 60 mg/m2 (DNA60), or daunorubicin 90 mg/m2 (DNA90)...
March 8, 2018: Leukemia Research
David B Yourman
When there are politically polarizing events taking place in the world, can it be useful for a therapist to disclose his or her political views within the context of a psychotherapeutic dyad? This paper examines this question through the example of a Marxist therapist working with a politically conservative patient in the polarized political atmosphere following Donald Trump's election to the Presidency of the United States. Also explored are the patient's dynamics that might have made it particularly salient for the therapist to eschew a more neutral stance...
March 15, 2018: Journal of Clinical Psychology
Guillermo Montalban-Bravo, Courtney D DiNardo
Isocitrate dehydrogenases (IDHs) are enzymes involved in multiple metabolic and epigenetic cellular processes. Mutations in IDH1 or IDH2 are detected in approximately 20% of patients with acute myeloid leukemia (AML) and induce amino acid changes in conserved residues resulting in neomorphic enzymatic function and production of an oncometabolite, 2-hydroxyglutarate (R-2-HG). This leads to DNA hypermethylation, aberrant gene expression, cell proliferation and abnormal differentiation. IDH mutations diversely affect prognosis of patients with AML based on the location of the mutation and other co-occurring genomic abnormalities...
March 15, 2018: Future Oncology
Gladstone C McDowell, Joseph Winchell
OBJECTIVES: The majority of patients seeking medical care for chronic pain consult a primary care physician (PCP). Because systemic opioids are commonly prescribed to patients with chronic pain, PCPs are attempting to balance the competing priorities of providing adequate pain relief while reducing risks for opioid misuse and overdose. It is important for PCPs to be aware of pain management strategies other than systemic opioid dose escalation when patients with chronic pain fail to respond to conservative therapies and to initiate a multimodal treatment plan...
March 15, 2018: Postgraduate Medicine
Jack Zigler, Nicole Ferko, Chris Cameron, Leena Patel
AIM: To compare the efficacy and safety of total disc replacement, lumbar fusion, and conservative care in the treatment of single-level lumbar degenerative disc disease (DDD). MATERIALS & METHODS: A network meta-analysis was conducted to determine the relative impact of lumbar DDD therapies on Oswestry Disability Index (ODI) success, back pain score, patient satisfaction, employment status, and reoperation. Odds ratios or mean differences and 95% credible intervals were reported...
March 2018: Journal of Comparative Effectiveness Research
Hiroshi Tamura, Tatsuo Kanda, Tadasu Chida, Hitoshi Kameyama, Ukihide Tateishi, Toshifumi Wakai, Makoto Naito
BACKGROUND: Pneumatosis cystoides intestinalis (PCI) is a rare disease characterized by multiple gas-filled cysts in the intestinal wall and is associated with various comorbidities. We report herein a case of intractable paralytic ileus caused by primary PCI. CASE PRESENTATION: A 73-year-old man visited out hospital complaining of abdominal pain and vomiting. He had been hospitalized twice for intestinal obstruction in the past 2 months. Based on his history of appendectomy, mechanical bowel obstruction caused by adhesion was diagnosed, and the patient underwent surgery...
March 14, 2018: Surgical Case Reports
Dennis DiGiorgi, John L Cerf, Daniel S Bowerman
Over a period of decades chiropractors have utilized spinal manipulation under anesthesia (SMUA) to treat chronic back and neck pain. As an advanced form of manual therapy, SMUA is reserved for the patient whose condition has proven refractory to office-based manipulation and other modes of conservative care. Historically, the protocols and guidelines put forth by chiropractic MUA proponents have served as the clinical compass for directing MUA practice. With many authors and MUA advocates having focused primarily on anticipated benefit, the published literature contains no resource dedicated to treatment precautions and contraindications...
2018: Chiropractic & Manual Therapies
Rizwan Haider, Muhammad Salman Bashir, Muhammad Adeel, Muhammad Junaid Ijaz, Azhar Ayub
OBJECTIVE: To determine the effect of conservative exercise therapy with and without Maitland thoracic manipulation in patients with subacromial pain. METHODS: The randomised controlled trial study was conducted at the Mayo Hospital, Lahore, Pakistan, from June 2015 to February 2016, and comprised patients with subacromial pain (group 1) and controls (group 2).Pre-assessment was done by using numeric pain rating scale and shoulder pain and disability index as subjective measurements, while range of motion was taken as objective measurement...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Nicla Porciello, Paola Grazioli, Antonio F Campese, Martina Kunkl, Silvana Caristi, Marta Mastrogiovanni, Michela Muscolini, Francesca Spadaro, Cédric Favre, Jacques A Nunès, Aldo Borroto, Balbino Alarcon, Isabella Screpanti, Loretta Tuosto
CD28 superagonistic antibodies (CD28SAb) can preferentially activate and expand immunosuppressive regulatory T cells (Treg) in mice. However, pre-clinical trials assessing CD28SAbs for the therapy of autoimmune diseases reveal severe systemic inflammatory response syndrome in humans, thereby implying the existence of distinct signalling abilities between human and mouse CD28. Here, we show that a single amino acid variant within the C-terminal proline-rich motif of human and mouse CD28 (P212 in human vs. A210 in mouse) regulates CD28-induced NF-κB activation and pro-inflammatory cytokine gene expression...
March 14, 2018: Nature Communications
Bangari Haldipur, Prudhvi Lal Bhukya, Vidya Arankalle, Kavita Lole
Molecular mechanisms of liver pathology and clinical disease in HEV infection remain unclear. MicroRNAs are known to modulate viral pathogenesis either by directly altering viral gene expression or by enhancing cellular antiviral responses. Given the importance of microRNA-122 (miR-122) in liver pathobiology, we investigated possible role of miR-122 in HEV infection. In silico predictions using genotype 1, 2, 3 and 4 HEV sequences showed that majority of genomes (203/222) harbor at least one miR-122/miR-122* target site...
March 14, 2018: Journal of Virology
Muharrem Yunce, Ashwyn Sharma, Evan Braunstein, Michael B Streiff, Ying Wei Lum
RATIONALE: Thoracic outlet syndrome (TOS) is a rare cause of upper extremity deep vein thrombosis (UEDVT). The treatment usually involves catheter directed thrombolysis followed by systemic anticoagulation. Surgical decompression is frequently recommended after anticoagulation for definitive therapy. PATIENT CONCERNS: We report two cases of UEDVT secondary to venous TOS with important clinical presentations. DIAGNOSES: Venous TOS. INTERVENTIONS: One patient was initially treated conservatively but had a recurrent UEDVT...
March 2018: Medicine (Baltimore)
David H Jang, Utsha G Khatri, Anita Mudan, Jennifer S Love, Shawn Owiredu, David M Eckmann
It is conservatively estimated that 5,000 deaths per year and 20,000 injuries in the USA are due to poisonings caused by chemical exposures (e.g., carbon monoxide, cyanide, hydrogen sulfide, phosphides) that are cellular inhibitors. These chemical agents result in mitochondrial inhibition resulting in cardiac arrest and/or shock. These cellular inhibitors have multi-organ effects, but cardiovascular collapse is the primary cause of death marked by hypotension, lactic acidosis, and cardiac arrest. The mitochondria play a central role in cellular metabolism where oxygen consumption through the electron transport system is tightly coupled to ATP production and regulated by metabolic demands...
March 13, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
Chandan Kanta Das, Mahitosh Mandal, Donat Kögel
Resistance to therapy is one of the prime causes for treatment failure in cancer and recurrent disease. In recent years, autophagy has emerged as an important cell survival mechanism in response to different stress conditions that are associated with cancer treatment and aging. Autophagy is an evolutionary conserved catabolic process through which damaged cellular contents are degraded after uptake into autophagosomes that subsequently fuse with lysosomes for cargo degradation, thereby alleviating stress. In addition, autophagy serves to maintain cellular homeostasis by enriching nutrient pools...
March 13, 2018: Cancer Metastasis Reviews
Qi Liu, Tian-Jia Li, Rong Zeng, Yue-Xin Chen, Wei Ye, Bao Liu, Chang-Wei Liu
Objective To investigate the optimal treatment strategy of spontaneous isolated dissection of superior mesenteric artery (SIDSMA) and the effect of anticoagulation therapy on the prognosis of SIDSMA. Methods The clinical data of 29 patients presented with acute or subacute mesenteric ischemia (a history of less than 14 days) due to SIDSMA admitted to the Department of Vascular Surgery of Peking Union Medical College Hospital from January 1st 2003 to December 31th 2016 were retrospectively analyzed. Results In this study,28 cases were male and the remaining one was female,with an average age of (49...
February 28, 2018: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Nicholas Yock Teck Soh, Nan Zun Teo, Carrie Jen Hsi Tan, Shivani Rajaraman, Marianne Tsang, Calvin Jian Ming Ong, Ramesh Wijaya
BACKGROUND: It is unclear if location of disease matters in perforated diverticulitis. Management guidelines for perforated diverticulitis currently do not make a distinction between right perforated diverticulitis (RPD) and left perforated diverticulitis (LPD). We aim to compare disease presentation and management outcomes between RPD and LPD. METHODS: This was a 10-year retrospective comparative cohort study of 99 patients with acute perforated diverticulitis between 2004 and 2013 in a single institution...
March 12, 2018: International Journal of Colorectal Disease
Takayuki Ueno, Shigehira Saji, Norikazu Masuda, Katsumasa Kuroi, Nobuaki Sato, Hiroyuki Takei, Yutaka Yamamoto, Shinji Ohno, Hiroko Yamashita, Kazufumi Hisamatsu, Kenjiro Aogi, Hiroji Iwata, Takeharu Yamanaka, Hironobu Sasano, Masakazu Toi
Background: Neoadjuvant endocrine therapy (NET) has been demonstrated to improve breast-conserving rate and is a widely accepted treatment option for postmenopausal patients with hormone receptor-positive breast cancer. There are few reports on the association of NET response and long-term outcomes. Objectives: To investigate the prognostic value of clinical response to NET. Methods: Long-term outcomes of NET were examined in 107 patients who participated in the multicentre prospective neoadjuvant exemestane study, JFMC34-0601...
2018: ESMO Open
Ashok Kumar Singh, Aditya Shukla, R Bajwa, Roshni Agrawal, Neha Srivastwa
Pulmonary nocardiosis is a rare disease, which mainly affects immunocompromised hosts such as uncontrolled diabetics; HIV patients; and patients on immunosuppressive therapies such as anticancer drugs, systemic steroids, and transplant recipients. The diagnosis is often missed and delayed, resulting in inappropriate treatment and thus higher mortality. We are reporting a case of pulmonary nocardiosis with acute presentation in an immune-competent host, who presented with community-acquired pneumonia to the Intensive Care Unit...
February 2018: Indian Journal of Critical Care Medicine
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