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https://www.readbyqxmd.com/read/29228499/high-dose-intravenous-immunoglobulins-for-the-treatment-of-dermatological-autoimmune-diseases
#1
Jochen H O Hoffmann, Alexander H Enk
Based on their immunomodulatory properties, high-dose intravenous immunoglobulins (IVIGs) are successfully used in the treatment of various dermatological autoimmune diseases, in particular pemphigus vulgaris and dermatomyositis. In autoimmune bullous diseases, IVIGs can be used in an adjuvant setting (second- or third-line therapy) once combined immunosuppressive regimens have failed. In dermatomyositis, IVIGs may already be employed as an adjuvant second-line therapy after failure of corticosteroid monotherapy...
December 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/29228200/ect-has-greater-efficacy-than-fluoxetine-in-alleviating-the-burden-of-illness-for-patients-with-major-depressive-disorder-a-taiwanese-pooled-analysis
#2
Ching-Hua Lin, Chun-Jen Huang, Cheng-Chung Chen
Background: The burden of major depressive disorder (MDD) includes suffering due to symptom severity, functional impairment, and quality of life (QOL) deficits. The aim of this study was to compare the differences between ECT and pharmacotherapy in reducing such burdens. Methods: This was a pooled analysis study including two open-label trials for MDD inpatients receiving either standard bitemporal and modified ECT with a maximum of 12 sessions, or 20 mg/d of fluoxetine for 6 weeks...
December 8, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29228130/acute-retroviral-syndrome-is-associated-with-high-viral-burden-cd4-depletion-and-immune-activation-in-systemic-and-tissue-compartments
#3
Trevor A Crowell, Donn J Colby, Suteeraporn Pinyakorn, James L K Fletcher, Eugène Kroon, Alexandra Schuetz, Shelly J Krebs, Bonnie M Slike, Louise Leyre, Nicolas Chomont, Linda L Jagodzinski, Irini Sereti, Netanya S Utay, Robin Dewar, Rungsun Rerknimitr, Nitiya Chomchey, Rapee Trichavaroj, Victor G Valcour, Serena Spudich, Nelson L Michael, Merlin L Robb, Nittaya Phanuphak, Jintanat Ananworanich
Background: Many individuals with acute HIV infection (AHI) experience acute retroviral syndrome (ARS), which is associated with adverse long-term clinical outcomes. We characterized clinical, virologic, and immunologic features of ARS and described the impact of early antiretroviral therapy (ART) initiation. Methods: Participants presenting for voluntary HIV testing were enrolled during AHI in Bangkok, Thailand. ARS was defined by ≥3 qualifying signs/symptoms...
December 7, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29227460/neuropathic-like-ocular-pain-and-nonocular-comorbidities-correlate-with-dry-eye-symptoms
#4
Victoria S Chang, Terri P Rose, Carol L Karp, Roy C Levitt, Constantine Sarantopoulos, Anat Galor
OBJECTIVE: To evaluate the association between dry eye (DE) symptoms and neuropathic-like ocular pain (NOP) features, chronic pain conditions, depression, and anxiety in patients presenting for routine ophthalmic examinations. METHODS: Two hundred thirty-three consecutive patients ≥18 years of age presenting to a comprehensive eye clinic between January and August 2016 were included in this study. Information on demographics, chronic pain conditions, medication use, DE symptoms (dry eye questionnaire, DEQ5), NOP complaints (burning; wind, light, and temperature sensitivity), depression, and anxiety indices (patient health questionnaire 9, PHQ-9 and symptom checklist 90-revised, SCL-90-R) were collected for each individual...
December 7, 2017: Eye & Contact Lens
https://www.readbyqxmd.com/read/29227453/effect-of-prophylactic-medication-on-associated-dizziness-and-motion-sickness-in-migraine
#5
Seung-Han Lee, Seong-Hae Jeong, Ji-Soo Kim, Hyo-Jung Kim, Kwang-Dong Choi, Jae-Hwan Choi, Sun-Young Oh, Ji-Yun Park, Dong Uk Kim, Byung-Kun Kim
OBJECTIVE: To determine the efficacy of prophylactic medications for migraine in reducing associated dizziness and motion sickness. STUDY DESIGN: Multicenter prospective observational study. SETTING: Nationwide 9 Dizziness Clinics in South Korea. PATIENTS: One hundred thirty-eight patients who required a preventive medication for migraine accompanied by dizziness and motion sickness. INTERVENTION: At least one of the prophylactic medications was prescribed among the beta-blockers, calcium channel blockers, tricyclic antidepressants, and antiepileptic drugs...
January 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29227295/an-unusual-presentation-of-pituitary-gland-apoplexy-with-noninfectious-meningitis
#6
Margaret LaPorte, Jenna Pollock, Michael Ward, James Fulcher
Pituitary adenomas make up 10% of intracranial tumors, but because of their location, they may go undetected for long periods. In this article, we report the case of a 68-year-old white man found deceased in his residence, who died of acute pituitary tumor apoplexy. He was known to have severe symptoms including acute headache, vision loss, and altered behavior. When found, his home was in extreme disarray, mimicking a possible assault. At autopsy, the decedent had multiple superficial abrasions about the upper and lower extremities, as well as a 2...
December 7, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29226741/side-effects-associated-with-current-and-prospective-antimigraine-pharmacotherapies
#7
Abimael González-Hernández, Bruno A Marichal-Cancino, Antoinette MaassenVanDenBrink, Carlos M Villalón
Migraine is a neurovascular disorder. Current acute specific antimigraine pharmacotherapies target trigeminovascular 5-HT1B/1D, 5-HT1F and CGRP receptors but, unfortunately, they induce some cardiovascular and central side effects that lead to poor treatment adherence/compliance. Therefore, new antimigraine drugs are being explored. Areas covered. This review considers the adverse (or potential) side effects produced by current and prospective antimigraine drugs, including medication overuse headache (MOH) produced by ergots and triptans, the side effects observed in clinical trials for the new gepants and CGRP antibodies, and a section discussing the potential effects resulting from disruption of the cardiovascular CGRPergic neurotransmission...
December 9, 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/29226626/randomized-clinical-study-of-safety-pharmacokinetics-and-pharmacodynamics-of-ripk1-inhibitor-gsk2982772-in-healthy-volunteers
#8
Kathleen Weisel, Nicola E Scott, Debra J Tompson, Bartholomew J Votta, Sujith Madhavan, Kat Povey, Allen Wolstenholme, Monica Simeoni, Todd Rudo, Lauren Richards-Peterson, Tarjinder Sahota, J Gene Wang, John Lich, Joshua Finger, Adeline Verticelli, Michael Reilly, Peter J Gough, Philip A Harris, John Bertin, Mei-Lun Wang
GSK2982772 is a highly selective inhibitor of receptor-interacting protein kinase 1 (RIPK1) being developed to treat chronic inflammatory diseases. This first-in-human study evaluated safety, tolerability, pharmacokinetics (PK), and exploratory pharmacodynamics (PD) of GSK2982772 administered orally to healthy male volunteers. This was a Phase I, randomized, placebo-controlled, double-blind study. In Part A, subjects received single ascending doses of GSK2982772 (0.1-120 mg) or placebo in a crossover design during each of 4 treatment periods...
December 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/29226466/childhood-onset-cluster-headache-observations-from-a-personal-case-series-and-review-of-the-literature
#9
Arens Taga, Gian Camillo Manzoni, Marco Russo, Maria Vittoria Paglia, Paola Torelli
BACKGROUND/OBJECTIVES: Puberty seems to be a turning point in cluster headache (CH) onset. To verify its influence on CH phenotype, we focused on cases with onset ≤13 years. A review of the literature follows. METHOD: We considered CH cases with age-of-onset ≤13 years evaluated at our center between 1975 and 2015; these cases were matched by sex to two consecutive patients with age-of-onset as close as possible (±2 years) to the median age-of-onset of the overall CH population...
December 11, 2017: Headache
https://www.readbyqxmd.com/read/29226314/sneezing-in-primary-headaches-with-cranial-autonomic-symptoms-pathophysiological-considerations-a-series-of-case-reports
#10
Sylvain Redon, Anne Donnet
OBJECTIVE: To report a case series of sneezing systematically occurring in two cases with migraine and cranial autonomic symptoms and two with cluster headache. BACKGROUND: Sneezing occurring systematically during cluster headache or migraine is a rare condition. Sneezing has been described as a specific trigger for migraine. METHODS: Case reports. CASE SERIES: We describe four patients with primary headaches, presenting systematic sneezing at a definite time of premonitory, postdromal, or headache phase...
December 11, 2017: Headache
https://www.readbyqxmd.com/read/29226050/determinants-of-computed-tomography-head-scan-ordering-for-patients-with-low-risk-headache-in-the-emergency-department
#11
Meaghan J Mackenzie, Rashi Hiranandani, Dongmei Wang, Tak Fung, Eddy Lang
Background Many specialty societies have found that neuroimaging in headache is a low-value intervention for benign presentations. This study describes factors that influence Emergency Room (ER) physicians' adherence to Choosing Wisely (CW) recommendations for low-risk headache patients presenting to Calgary's Emergency Departments (EDs). Emergency medicine has yet to address imaging in headache as a CW topic; however, this study may inform that decision. Methods Data were retrospectively collected for all patients presenting to Calgary EDs with headaches from April 1, 2014 to March 31, 2016...
October 9, 2017: Curēus
https://www.readbyqxmd.com/read/29225682/frontal-lobe-meningioma-mimicking-preeclampsia-a-case-study
#12
Jinny Y Foo, Gregory K Davis, Mark A Brown
We report a case of a left frontal lobe meningioma presenting in a woman with proteinuric preeclampsia in her first term pregnancy. The patient had a background of antepartum migraines that resolved in the second trimester of pregnancy. Postpartum, she required urgent surgery and sustained convulsions after surgery. She had no residual disease and has had another successful pregnancy. This case highlights the importance of cerebral imaging in the context of an atypical clinical course of preeclampsia. Although headaches are common in pregnancy and usually benign, other, more serious, diagnoses should be considered with atypical headaches, a change in the nature of the headache, and headaches that persist despite appropriate treatment...
December 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/29225576/vitamin-d-enhances-efficacy-of-oral-nifedipine-in-treating-preeclampsia-with-severe-features-a-double-blinded-placebo-controlled-and-randomized-clinical-trial
#13
Dan-Dan Shi, Yong Wang, Jun-Jun Guo, Ling Zhou, Na Wang
Vitamin D (VD) has exhibited immunomodulatory role in the pathogenesis of preeclampsia. We hypothesize VD potentiate nifedipine treatment for preeclampsia by shortened the time to control blood pressure and prolong time before subsequent hypertensive crisis. We conduct a randomized trial of 683 primigravid women with preeclampsia, who were assigned to different treatment groups, either nifedipine+placebo or nifedipine+VD orally, by random after screening. Primary endpoints include time to control hypertension and time before another hypertensive crisis...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29223998/cryptococcal-meningitis-in-apparently-immunocompetent-patients-association-with-idiopathic-cd4-lymphopenia
#14
Samuel Shribman, Alastair Noyce, Sharmilee Gnanapavan, Jonathan Lambourne, Thomas Harrison, Frederick Schon
We present two cases of cryptococcal meningitis in people subsequently diagnosed with idiopathic CD4+ lymphopenia. Both presented with new onset headaches without sinister features and were sent home on multiple occasions from emergency departments. Cryptococcal meningitis in HIV-negative patients poses major diagnostic and management problems; the associated mortality is 9%-27%. We suggest performing blood and cerebrospinal fluid cryptococcal antigen tests in all people with lymphocytic meningitis.
December 9, 2017: Practical Neurology
https://www.readbyqxmd.com/read/29223727/urodynamic-characteristics-might-be-variable-in-bladder-pain-syndrome-interstitial-cystitis-patients-with-different-non-bladder-co-morbid-conditions
#15
Wei-Ming Cheng, Yu-Hua Fan, Alex T L Lin
BACKGROUND: The aim of the study was to identify the impact of non-bladder co-morbid conditions on the urodynamic characteristics of patients with bladder pain syndrome/interstitial cystitis. METHODS: Patients with bladder pain syndrome/interstitial cystitis completed the screening questionnaires for chronic fatigue syndrome, irritable bowel syndrome, fibromyalgia, temporo-mandibular disorders, multiple chemical sensitivities, tension/migraine headache, and localized myofascial pain disorder...
December 6, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29223694/atraumatic-versus-conventional-lumbar-puncture-needles-a-systematic-review-and-meta-analysis
#16
Siddharth Nath, Alex Koziarz, Jetan H Badhiwala, Waleed Alhazzani, Roman Jaeschke, Sunjay Sharma, Laura Banfield, Ashkan Shoamanesh, Sheila Singh, Farshad Nassiri, Wieslaw Oczkowski, Emilie Belley-Côté, Ray Truant, Kesava Reddy, Maureen O Meade, Forough Farrokhyar, Malgorzata M Bala, Fayez Alshamsi, Mette Krag, Itziar Etxeandia-Ikobaltzeta, Regina Kunz, Osamu Nishida, Charles Matouk, Magdy Selim, Andrew Rhodes, Gregory Hawryluk, Saleh A Almenawer
BACKGROUND: Atraumatic needles have been proposed to lower complication rates after lumbar puncture. However, several surveys indicate that clinical adoption of these needles remains poor. We did a systematic review and meta-analysis to compare patient outcomes after lumbar puncture with atraumatic needles and conventional needles. METHODS: In this systematic review and meta-analysis, we independently searched 13 databases with no language restrictions from inception to Aug 15, 2017, for randomised controlled trials comparing the use of atraumatic needles and conventional needles for any lumbar puncture indication...
December 6, 2017: Lancet
https://www.readbyqxmd.com/read/29223275/a-26-year-old-man-from-mexico-with-headaches-dysuria-and-a-right-scrotal%C3%A2-mass
#17
Vanessa Correa, Janine Vintch, Charles Lanks
A 26-year-old man with no medical history was admitted to the hospital for evaluation of his change in mental status. He was noted to be agitated at work and had difficulty walking for 2 days before being brought in to the ED by his family. According to his uncle, the patient had been complaining of a headache and pain with urination for approximately 1 week. He was born in Guerrero, Mexico (a small farm town), and moved to Los Angeles, California, in 2008.
December 2017: Chest
https://www.readbyqxmd.com/read/29222573/incidence-and-causes-of-overdiagnosis-of-optic-neuritis
#18
Leanne Stunkel, Nathan H Kung, Bradley Wilson, Collin M McClelland, Gregory P Van Stavern
Importance: Diagnostic error is an important source of medical error. Overdiagnosis of optic neuritis may prompt unnecessary and costly diagnostic tests, procedures, and treatments. Objective: To assess the incidence of and characterize factors contributing to overdiagnosis of acute optic neuritis. Design, Setting, and Participants: In this retrospective clinic-based cross-sectional study of new patient encounters, 122 patients referred for acute optic neuritis at a university-based Midwestern neuro-ophthalmology clinic between January 2014 and October 2016 were studied...
December 7, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29222208/hypersomatotropism-induced-secondary-polycythaemia-leading-to-spontaneous-pituitary-apoplexy-resulting-in-cure-of-acromegaly-and-remission-of-polycythaemia-the-virtuous-circle
#19
Shinjan Patra, Sugata Narayan Biswas, Joydip Datta, Partha Pratim Chakraborty
A young man with subtle clinical features suggestive of hypersomatotropism presented with acute-onset severe headache. Relevant investigations confirmed polycythaemia and growth hormone (GH)-secreting pituitary macroadenoma with apoplexy. Secondary polycythaemia and myeloproliferative disorders were ruled out. At follow-up after 3 months, resolution of polycythaemia and acromegaly was observed, evident on normal haemoglobin levels, a normocellular marrow, and normal insulin-like growth factor-1 (IGF-1) with glucose-suppressed GH levels...
December 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29222182/fifteen-minute-consultation-an-approach-to-the-child-with-chronic-headaches
#20
Nichola Aspinall, Anita D'Urso, Gautam Ambegaonkar
Children with chronic headache are a common referral to paediatric outpatients. This article suggests an approach to the assessment and management of chronic headaches, offering practical strategies for management as there is limited literature in paediatrics for this.
December 8, 2017: Archives of Disease in Childhood. Education and Practice Edition
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