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Treatment goals

J Michael Dickson, Xu Wang, Alexander E St John, Esther B Lim, Susan A Stern, Nathan J White
Introduction: Traumatic brain injury (TBI) and hemorrhagic shock (HS) are the leading causes of traumatic death worldwide and particularly on the battlefield. They are especially challenging when present simultaneously (polytrauma), and clear blood pressure end points during fluid resuscitation are not well described for this situation. The goal of this study is to evaluate for any benefit of increasing blood pressure using a vasopressor on brain blood flow during initial fluid resuscitation in a swine polytrauma model...
March 14, 2018: Military Medicine
Soo Lim, Robert H Eckel, Kwang Kon Koh
The final goal in the management of patients with type 2 diabetes (T2D) is reduction in cardiovascular (CV) complications and total mortality. Various factors including hyperglycemia contribute to these complications and mortality directly and indirectly. In recent years, large-scale CV outcome trials with new antidiabetic medications, such as dipeptidyl peptidase-4 (DPP4) inhibitors, glucagon-like peptide-1 (GLP1) receptor agonists, and sodium glucose cotransporter-2 (SGLT2) inhibitors, have been completed...
March 8, 2018: Atherosclerosis
Petra Bachour, Stephen T Sonis
PURPOSE OF REVIEW: The goals of this review are to describe the complexity of factors influencing the risk of cancer regimen-related mucosal injury (CRRMI), to evaluate the contribution of the innate immune response to CRRMI risk, to compare the concordance of genome analytics in describing mechanism and risk, and to determine if common biological pathways are noted when CRRMI is compared to a disease with a similar phenotype. RECENT FINDINGS: The pathogenesis of and risk for CRRMI are complex and influenced by multiple intrinsic and extrinsic factors...
March 14, 2018: Current Opinion in Supportive and Palliative Care
Aleksandra Klobučar, Vera Folnegović-Šmalc, Dubravka Kocijan-Hercigonja, Slavica Sović, Ljiljana Gulić
BACKGROUND: The main goal of this study was to analyse and show clinical characteristics and psychiatric comorbidity in 38 participants aged between 10 and 17 with DSM-IV diagnoses of Trichotillomania (TTM) that we were treating at Children's Hospital Zagreb from 2008 to 2017. SUBJECTS AND METHODS: We analyzed the data obtained from semi-structured interviews by the criteria of DSM-IV, Youth Self Report (YSR) (Achenbach & Rescorla 2001) and survey that we created...
March 2018: Psychiatria Danubina
Russell Blackwelder
Aligning patient goals with treatment plans is an ongoing challenge in the current healthcare environment. Particularly in patients with multiple comorbidities and terminal illness, this planning is even more important. This poem, which tells the story of a dying patient, highlights the significance of prioritizing patient values and the teamwork it often takes to achieve patient goals. In this case, the patient's goal was to make it to his granddaughter's wedding and give a special toast at the reception. A team of healthcare professionals assembled and attempted to align our objectives with his, and this poem tells of that journey...
January 1, 2018: International Journal of Psychiatry in Medicine
Lijun Ding, Guijun Yan, Bin Wang, Lu Xu, Yan Gu, Tong Ru, Xiaoying Cui, Lei Lei, Jingyu Liu, Xiaoqiang Sheng, Bin Wang, Chunxue Zhang, Yanjun Yang, Ruiwei Jiang, Jianjun Zhou, Na Kong, Feifei Lu, Huaijun Zhou, Yannan Zhao, Bing Chen, Yali Hu, Jianwu Dai, Haixiang Sun
Premature ovarian failure (POF) is a refractory disease for clinical treatment with the goal of restoring fertility. In this study, umbilical cord mesenchymal stem cells on a collagen scaffold (collagen/UC-MSCs) can activate primordial follicles in vitro via phosphorylation of FOXO3a and FOXO1. Transplantation of collagen/UC-MSCs to the ovaries of POF patients rescued overall ovarian function, evidenced by elevated estradiol concentrations, improved follicular development, and increased number of antral follicles...
March 13, 2018: Science China. Life Sciences
Caterina Musolino, Giacomo Oteri, Alessandro Allegra, Manuela Mania, Angela D'Ascola, Angela Avenoso, Vanessa Innao, Andrea Gaetano Allegra, Salvatore Campo
Bisphosphonates are formidable inhibitors of osteoclast-mediated bone resorption employed for therapy of multiple myeloma (MM) subjects with osteolytic lesions. Osteonecrosis of the jaw (ONJ) is an uncommon drug-induced adverse event of these agents. MicroRNAs (miRNAs) are a group of small, noncoding RNAs nucleotides, which are essential post-transcriptional controllers of gene expression. They have a central role in the normal bone development. The goal of our study was to investigate 18 miRNAs, whose targets were previously validated and described in MM subjects without ONJ, in peripheral lymphocytes of MM subjects with bisphosphonate-induced ONJ...
March 15, 2018: Annals of Hematology
Gabriele Miotto, Yan Ortiz-Pomales
Arm contour improvement is a desired goal of the massive weight loss and the aging population who want to maintain the arm aesthetics. Brachioplasty is a growing and safe procedure to improve the arm contour and different approaches and innovative treatment options have been described since the 1930s. This paper reviews the relevant literature in arm contouring including surgical and nonsurgical procedures used to aesthetically improve the arm. A comprehensive literature review was performed using the words "brachioplasty," "arm lift," "arm contouring," "arm liposuction," "noninvasive arm lift," "minimally invasive arm lift...
March 12, 2018: Aesthetic Surgery Journal
Natalia A Trayanova, Patrick M Boyle, Plamen P Nikolov
The goal of this article is to review advances in computational modeling of the heart, with a focus on recent non-invasive clinical imaging- and simulation-based strategies aimed at improving the diagnosis and treatment of patients with arrhythmias and structural heart disease. Following a brief overview of the field of computational cardiology, we present recent applications of the personalized virtual-heart approach in predicting the optimal targets for infarct-related ventricular tachycardia and atrial fibrillation ablation, and in determining risk of sudden cardiac death in myocardial infarction patients...
March 2018: Current Opinion in Biomedical Engineering
Zhiqi Xie, Wangwei Guo, Ningning Guo, Mingyi Huangfu, Huina Liu, Mengting Lin, WenHong Xu, Jiejian Chen, TianTian Wang, Qichun Wei, Min Han, Jianqing Gao
Although existing nanomedicines have focused on the tumor microenvironment with the goal of improving the effectiveness of conventional chemotherapy, the penetration of a tumor's core still represents a formidable barrier for existing drug delivery systems. Therefore, a novel multifunctional hypoxia-induced size-shrinkable nanoparticle has been designed to increase the penetration of drugs, nucleic acids, or probes into tumors. This cooperative strategy relies on three aspects: (i) the responsiveness of nanoparticles to hypoxia, which shrink when triggered by low oxygen concentrations; (ii) the core of a nanoparticle involves an internal cavity and strong positive charges on the surface to deliver both doxorubicin and siRNA; and (iii) a reactive oxygen species (ROS) probe is incorporated in the nanoparticle to monitor its preliminary therapeutic response in real time, which is expected to realize the enhanced efficacy together with the ability to self-monitor the anticancer activity...
March 12, 2018: Acta Biomaterialia
Benjamin D Smith, Jennifer R Bellon, Rachel Blitzblau, Gary Freedman, Bruce Haffty, Carol Hahn, Francine Halberg, Karen Hoffman, Kathleen Horst, Jean Moran, Caroline Patton, Jane Perlmutter, Laura Warren, Timothy Whelan, Jean L Wright, Reshma Jagsi
INTRODUCTION: The purpose of this guideline is to offer recommendations on fractionation for whole breast irradiation (WBI) with or without a tumor bed boost and guidance on treatment planning and delivery. METHODS AND MATERIALS: The American Society for Radiation Oncology (ASTRO) convened a task force to address 5 key questions focused on dose-fractionation for WBI, indications and dose-fractionation for tumor bed boost, and treatment planning techniques for WBI and tumor bed boost...
March 8, 2018: Practical Radiation Oncology
Agnieszka Montusiewicz, Marta Bis, Sylwia Pasieczna-Patkowska, Dariusz Majerek
The main goal of this study was to investigate the co-digestion of sewage sludge and mature landfill leachate pretreated through hydrodynamic cavitation. The process efficiency was analyzed from the aspects of organics removal, biogas production, kinetics and digestate quality. Energy efficiency of the overall treatment was evaluated as well. A dose of hydrodynamically cavitated leachate of 5% v/v was used as a substrate for co-digestion with sewage sludge at a hydraulic retention time of 20 days. This improved the kinetics, biogas production and corresponding yields, as well as digestate quality...
March 12, 2018: Waste Management
Sara Moccia, Elena De Momi, Sara El Hadji, Leonardo S Mattos
BACKGROUND: Blood vessel segmentation is a topic of high interest in medical image analysis since the analysis of vessels is crucial for diagnosis, treatment planning and execution, and evaluation of clinical outcomes in different fields, including laryngology, neurosurgery and ophthalmology. Automatic or semi-automatic vessel segmentation can support clinicians in performing these tasks. Different medical imaging techniques are currently used in clinical practice and an appropriate choice of the segmentation algorithm is mandatory to deal with the adopted imaging technique characteristics (e...
May 2018: Computer Methods and Programs in Biomedicine
Daniela Filipa Rodrigues Pinho, Cátia Real, Leónia Ferreira, Pedro Pina
BACKGROUND AND OBJECTIVES: Currently there is no agreement regarding which one is the most adequate anesthetic technique for the treatment of retinopathy of prematurity. Peribulbar block may reduce the incidence of oculocardiac reflex and postoperative apnea. The goal of this study was to report the outcomes of peribulbar block, when combined with general anesthesia, for the laser treatment for retinopathy of prematurity, in premature babies. METHODS: A retrospective analysis of anesthetic records of all babies who underwent laser treatment for retinopathy of prematurity from January 2008 through December 2015 in a tertiary hospital was performed...
March 12, 2018: Revista Brasileira de Anestesiologia
Til Wykes, Eileen Joyce, Tjasa Velikonja, Andrew Watson, Gregory Aarons, Max Birchwood, Matteo Cella, Sue Dopson, David Fowler, Kathy Greenwood, Sonia Johnson, Paul McCrone, Jesus Perez, Andrew Pickles, Clare Reeder, Diana Rose, Swaran Singh, Dominic Stringer, Matthew Taylor, Rumina Taylor, Rachel Upthegrove
BACKGROUND: Cognitive problems in people with schizophrenia predict poor functional recovery even with the best possible rehabilitation opportunities and optimal medication. A psychological treatment known as cognitive remediation therapy (CRT) aims to improve cognition in neuropsychiatric disorders, with the ultimate goal of improving functional recovery. Studies suggest that intervening early in the course of the disorder will have the most benefit, so this study will be based in early intervention services, which treat individuals in the first few years following the onset of the disorder...
March 15, 2018: Trials
Michael J Fay, Lauren A C Alt, Dominika Ryba, Ribhi Salamah, Ryan Peach, Alexander Papaeliou, Sabina Zawadzka, Andrew Weiss, Nil Patel, Asad Rahman, Zyaria Stubbs-Russell, Peter C Lamar, Joshua R Edwards, Walter C Prozialeck
Cadmium (Cd) is a nephrotoxic environmental pollutant that causes a generalized dysfunction of the proximal tubule characterized by polyuria and proteinuria. Even though the effects of Cd on the kidney have been well-characterized, the molecular mechanisms underlying these effects have not been fully elucidated. MicroRNAs (miRNAs) are small non-coding RNAs that regulate cellular and physiologic function by modulating gene expression at the post-transcriptional level. The goal of the present study was to determine if Cd affects renal cortex miRNA expression in a well-established animal model of Cd-induced kidney injury...
March 15, 2018: Toxics
Eleonore V Grant, Adam H Skolnick, Joshua Chodosh, Michael H Perskin, Nicole M Orr, Caroline Blaum, John A Dodson
More than 13 million persons in the United States aged 65 and older have cardiovascular disease (CVD), and this population is expected to increase exponentially over the next several decades. In the absence of clinical studies that would inform how best to manage this population, there is an urgent need for collaborative, thoughtful approaches to their care. Although cardiologists are traditionally regarded as leaders in the care of older adults with CVD, these individuals have multiple comorbidities, physiological differences, and distinct goals of care than younger patients that require a specialized geriatric lens...
March 15, 2018: Journal of the American Geriatrics Society
Maria E Piroli, Ehsan Jabbarzadeh
Human stem cells hold significant potential for the treatment of various diseases. However, their use as a therapy is hampered because of limited understanding of the mechanisms by which they respond to environmental stimuli. Efforts to understand extracellular biophysical cues have demonstrated the critical roles of geometrical and mechanical signals in determining the fate of stem cells. The goal of this study was to explore the interplay between cell polarity and matrix stiffness in stem cell lineage specification...
March 14, 2018: Annals of Biomedical Engineering
Michael V Fiandalo, John J Stocking, Elena A Pop, John H Wilton, Krystin M Mantione, Yun Li, Kristopher M Attwood, Gissou Azabdaftari, Yue Wu, David S Watt, Elizabeth M Wilson, James L Mohler
Androgen deprivation therapy (ADT) is palliative and prostate cancer (CaP) recurs as lethal castration-recurrent/resistant CaP (CRPC). One mechanism that provides CaP resistance to ADT is primary backdoor androgen metabolism, which uses up to four 3α-oxidoreductases to convert 5α-androstane-3α,17β-diol (DIOL) to dihydrotestosterone (DHT). The goal was to determine whether inhibition of 3α-oxidoreductase activity decreased conversion of DIOL to DHT. Protein sequence analysis showed that the four 3α-oxidoreductases have identical catalytic amino acid residues...
February 16, 2018: Oncotarget
Sreedhar R Tummalapalli, Rohit Bhat, Agnieszka Chojnowski, Monika Prorok, Tamara Kreiss, Ronald Goldberg, Stacie Canan, Natalie Hawryluk, Deborah Mortensen, Vikram Khetani, Jerome Zeldis, John J Siekierka, David P Rotella
Lymphatic filariasis infects over 120 million people worldwide and can lead to significant disfigurement and disease. Resistance is emerging with current treatments, and these therapies have dose limiting adverse events; consequently new targets are needed. One approach to achieve this goal is inhibition of parasitic protein kinases involved in circumventing host defense mechanisms. This report describes structure-activity relationships leading to the identification of a potent, orally bioavailable stress activated protein kinase inhibitor that may be used to investigate this hypothesis...
March 8, 2018: ACS Medicinal Chemistry Letters
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