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https://www.readbyqxmd.com/read/29331604/efficacy-of-intravenous-lidocaine-on-pain-relief-in-patients-undergoing-laparoscopic-cholecystectomy-a-meta-analysis-from-randomized-controlled-trials
#1
REVIEW
M M Jinyuan Li, M M Gang Wang, M M Weituan Xu, M M Mei Ding, M D Wenli Yu
OBJECTIVE: Whether intravenous lidocaine has a beneficial role in controlling acute pain after a laparoscopic cholecystectomy (LC) in currently unknown. We performed a meta-analysis from randomized controlled trials (RCTs) to determine the efficacy and safety of intravenous lidocaine for the treatment of acute postoperative pain after LC. METHODS: In August 2017, a systematic search was performed in PubMed, EMBASE, Web of Science, ScienceDirect, and the Cochrane Library...
January 10, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29331343/irradiation-stents-vs-conventional-metal-stents-for-unresectable-malignant-biliary-obstruction-a-multicentre-trial
#2
Hai-Dong Zhu, Jin-He Guo, Ming Huang, Jian-Song Ji, Hao Xu, Jian Lu, Hai-Liang Li, Wen-Hui Wang, Yu-Liang Li, Cai-Fang Ni, Hai-Bin Shi, En-Hua Xiao, Wei-Fu Lv, Jun-Hui Sun, Ke Xu, Guo-Hong Han, Lin-An Du, Wei-Xin Ren, Mao-Quan Li, Ai-Wu Mao, Hua Xiang, Kai-Xian Zhang, Jie Min, Guang-Yu Zhu, Chang Su, Li Chen, Gao-Jun Teng
BACKGROUND & AIMS: Placement of an irradiation stent has been demonstrated to offer longer patency and survival when compared to an uncovered SEMS in patients with unresectable malignant biliary obstruction (MBO). We aim to further assess the efficacy of an irradiation stent compared to an uncovered SEMS in those patients. METHODS: We performed a randomized, open-label trial of participants with unresectable MBO at 20 centers in China. A total of 328 participants were parallelly allocated into the irradiation stent group (ISG) or the uncovered SEMS group (USG)...
January 10, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29331005/pregnant-lady-with-undiagnosed-hodgkin-s-disease-presenting-as-secondary-sclerosing-cholangitis
#3
Taif Khattak, Syed Hashim Ali Shah, Waqas Khan, Syed Shahmeer Raza, Uzair Ahmad, Farhan Ullah
Hodgkin's lymphoma. A 25 years old lady, 34 weeks primigravida was referred from the Emergency Department to the Medical Unit Khyber Teaching Hospital-MTI, Peshawar with four weeks of fever, progressive jaundice, pruritus, night sweats and weight loss. LFTs showed cholestatic picture, ERCP showed scanty intrahepatic giving beading and autumn tree appearance typical of sclerosing cholangitis. CBD was normal. Doppler U/S of hepatic and portal vein reported normal. She was started on steroids, ursodeoxycholic acid and antibiotics 3rd generation cephalosporins to which she did not respond well...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29327474/long-term-effects-of-intralymphatic-immunotherapy-ilit-on-canine-atopic-dermatitis
#4
Katrin Timm, Ralf S Mueller, Claudia S Nett-Mettler
BACKGROUND: Subcutaneous allergen immunotherapy (SCIT) is an established and efficacious therapy for canine atopic dermatitis (AD). In humans, intralymphatic immunotherapy (ILIT) was reported to be associated with fewer and less severe adverse effects than subcutaneous allergen immunotherapy and to be efficacious for several years after three intralymphatic injections. OBJECTIVE: To evaluate safety and effects of ILIT in a case series of dogs with (AD). ANIMALS: Fifty one privately owned dogs with AD...
January 12, 2018: Veterinary Dermatology
https://www.readbyqxmd.com/read/29326339/ninety-year-old-man-with-hypereosinophilia-lymphadenopathies-and-pruritus
#5
José Guilherme Freitas, Ana Jorge, Daniel Rei, Joana Graça
We report a case of a 90-year-old man with hypereosinophilia, lymphadenopathies and skin lesions, namely lichenification and pruritus. An aetiological investigation was performed, and a bone marrow (BM) biopsy and aspirate showed a hypercellular marrow with hypereosinophilia without dysmorphia or abnormal elements, and the BM and inguinal node's immunophenotyping denied any presence of abnormal lymphoid cell population. The inguinal node biopsy revealed a multinodular proliferation of large cells S100 and CD1a+, and a diagnosis of Langerhans cell histiocytosis was made...
January 10, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29324620/diagnosis-and-treatment-of-vulvar-dermatoses
#6
Colleen K Stockdale, Lori Boardman
Vulvar symptoms of pain, dyspareunia, and pruritus are common and may significantly affect a woman's sense of well-being and sexual function. Despite this, vulvar symptoms are often underreported by women. When identified, however, vulvovaginal symptoms should be addressed by health care providers to optimize care. The evaluation of patients with vulvovaginal complaints begins with a thorough history and physical examination. Biopsy is indicated when concern exists for malignancy or the diagnosis is uncertain...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29321547/polycythemia-vera-treatment-algorithm-2018
#7
REVIEW
Ayalew Tefferi, Alessandro M Vannucchi, Tiziano Barbui
Recently reported mature survival data have confirmed the favorable prognosis in polycythemia vera (PV), with an estimated median survival of 24 years, in patients younger than age 60 years old. Currently available drugs for PV have not been shown to prolong survival or alter the natural history of the disease and are instead indicated primarily for prevention of thrombosis. Unfortunately, study endpoints that are being utilized in currently ongoing clinical trials in PV do not necessarily target clinically or biologically relevant outcomes, such as thrombosis, survival, or morphologic remission, and are instead focused on components of disease palliation...
January 10, 2018: Blood Cancer Journal
https://www.readbyqxmd.com/read/29319283/pruritus-in-neurofibromatosis-type-1
#8
Emanuele Miraglia, Stefano Calvieri, Sandra Giustini
No abstract text is available yet for this article.
February 2018: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/29317591/an-unusual-presentation-of-advanced-intrahepatic-cholangiocarcinoma-when-biopsy-results-fail
#9
Joseph J Tasch, Nirva Dube
BACKGROUND Intrahepatic cholangiocarcinoma is a rare condition which typically occurs in males between 50 and 70 years of age, and presents with symptoms related to biliary obstruction including jaundice, pruritus, and dark urine. Other common symptoms at presentation include abdominal pain, weight loss, and fever. CASE REPORT We present a case of a 67-year-old female initially presenting with chest pain at rest, found to have a lung nodule on diagnostic imaging at the time of admission. On further imaging, a 9 cm liver lesion was incidentally discovered, initially suspicious for hepatocellular carcinoma on imaging, with initial biopsy staining CK7 positive, and CK20 negative...
January 10, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29317281/an-assessment-of-the-use-of-antihistamines-in-the-management-of-atopic-dermatitis
#10
Alice He, Steven R Feldman, Alan B Fleischer
BACKGROUND: Antihistamines are often used to treat pruritus associated with atopic dermatitis (AD) despite lack of evidence for their efficacy. The American Academy of Dermatology does not recommend the general use of antihistamines in the management of AD, although the value of short-term sedating antihistamine use for insomnia secondary to itch is recognized. OBJECTIVE: To assess the use of sedating and non-sedating antihistamines for AD from 2003-2012. METHODS: The National Ambulatory Medical Care Survey (NAMCS) provided data on physician visits from 2003-2012...
January 6, 2018: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29317264/the-genetics-of-chronic-itch-gene-expression-in-the-skin-of-atopic-dermatitis-and-psoriasis-patients-with-severe-itch
#11
Leigh A Nattkemper, Hong Liang Tey, Rodrigo Valdes-Rodriguez, Helen Lee, Nicholas K Mollanazar, Christian Albornoz, Kristen M Sanders, Gil Yosipovitch
To identify itch-related mediators and receptors that are differentially expressed in pruritic skin, we used RNA sequencing to analyze the complete transcriptome in skin from paired itchy, lesional and non-itchy, non-lesional skin biopsies from 25 atopic dermatitis (AD) and 25 psoriasis patients and site-matched biopsies from 30 healthy controls. This analysis identified 18,000 differentially expressed genes common between itchy atopic and psoriatic skin compared to healthy skin. Of those, almost 2,000 genes were differentially expressed between itchy and non-itchy skin in atopic and psoriatic subjects...
January 6, 2018: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/29317077/the-pruritus-of-cholestasis-from-bile-acids-to-opiate-agonists-relevant-after-all-these-years
#12
Nora V Bergasa
The pruritus of cholestasis is a maddening complication of liver disease. Increased opioidergic tone contributes to the pruritus of cholestasis, as evidenced by the amelioration of the symptom by opiate antagonists. Obeticholic acid, an agonist of the farnesoid receptor, has been approved for the treatment of primary biliary cholangitis, a disease characterized by cholestasis; this drug is associated with pruritus, the cause of which is unknown. In animal models, bile acids, which accumulate in the body as a result of cholestasis, have been reported to cause scratching behavior mediated by the TGR5 receptor, in an opioid-dependent manner, in laboratory animals...
January 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29314223/delayed-type-hypersensitivity-to-vaccine-aluminum-adjuvant-causing-subcutaneous-leg-mass-and-urticaria-in-a-child
#13
Samantha C Gordon, Diana W Bartenstein, Shahein H Tajmir, Johanna S Song, Elena B Hawryluk
A 3-year-old girl presented with a 7-month history of a waxing and waning left thigh mass associated with pruritus and erythema at the site of two previous DTaP-HepB-IPV vaccinations. Patch testing was positive to aluminum chloride, supporting a diagnosis of vaccine granuloma secondary to aluminum allergy; her symptoms had been well controlled with antihistamines and topical steroids. Injection site granulomas are a benign but potentially bothersome reaction to aluminum-containing immunizations that can be supportively managed, and we encourage strict adherence to the recommended vaccine schedule in this setting...
January 4, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29314207/vitiligoid-variant-of-lichen-sclerosus-in-young-girls-with-darker-skin-types
#14
Margaret H Dennin, Sarah L Stein, Adena E Rosenblatt
BACKGROUND/OBJECTIVES: Vitiligo and lichen sclerosus are autoimmune disorders characterized by white discoloration, and both frequently affect the anogenital region. Vitiligoid lichen sclerosus refers to a superficial variant of lichen sclerosus in which the lesion appears clinically to be vitiligo based on the predominant presentation of depigmentation and minimal inflammation and sclerosis but histologically is consistent with lichen sclerosus. A limited number of reports have described vitiligoid lichen sclerosus, and from these reports, it appears to primarily affect darker-skinned people...
January 4, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29314146/sofosbuvir-plus-daclatasvir-with-or-without-ribavirin-in-551-patients-with-hepatitis-c-related-cirrhosis-genotype-4
#15
H El-Khayat, Y Fouad, H I Mohamed, H El-Amin, E M Kamal, M Maher, A Risk
BACKGROUND: The Daclatasvir and Sofosbuvir combination therapy (SOF/DCV) has shown efficacy in patients with chronic hepatitis C in clinical trials. AIM: To investigate the efficacy and safety of SOF/DCV for treatment of patients with hepatitis C-related liver cirrhosis genotype 4. METHODS: Multicentre study involving 551 patients with liver cirrhosis genotype 4; 432 naïve patients and 119 treatment-experienced patients. All patients received SOF (400 mg) and DCV (60 mg) daily in addition to weight-based ribavirin (RBV) for 12 weeks and when RBV is contraindicated the treatment duration was extended to 24 weeks...
January 3, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29312544/efficacy-and-safety-of-dupilumab-for-the-treatment-of-moderate-to-severe-atopic-dermatitis-in-adults
#16
Xinghua Xu, Yi Zheng, Xin Zhang, Yanling He, Chengxin Li
Objective: Atopic dermatitis is a chronic, relapsing inflammatory skin disease characterized by intense pruritus, excoriations and limited therapies. Dupilumab, a monoclonal antibody against interleukin-4 receptor alpha, is a promising new treatment option for atopic dermatitis. We sought to systematically summarize the efficacy, safety, and influence on quality of life of dupilumab for the treatment of moderate-to-severe atopic dermatitis in adults. Results: A total of 7 RCTs containing 2705 subjects were identified...
December 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/29311728/editorial-itching-to-know-role-of-fibrates-in-pbc
#17
Cynthia Levy, Keith D Lindor
Approximately one-third of patients with primary biliary cholangitis (PBC) fail to respond to ursodeoxycholic acid (UDCA) and are at risk for progression to biliary cirrhosis and end-stage liver disease. In this paper by Pares et al., the authors evaluate the effect of long-term use of bezafibrate in patients with primary biliary cholangitis (PBC) and inadequate response to UDCA. They found that addition of bezafibrate led to normalization of serum alkaline phosphatase in half of the study subjects and major improvement in pruritus...
January 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29310470/new-therapies-target-the-toxic-consequences-of-cholestatic-liver-disease
#18
Peter L M Jansen
Introduction In most cholestatic liver diseases the primary cholestasis-causing lesions are located in the biliary tree and may be of (auto)immune origin. Bile salts are responsible for the secondary toxic consequences. Bile salt and nuclear hormone directed therapies primarily aim at improving this secondary toxic injury. In primary biliary cholangitis, trials show statistically significant responses on biochemical endpoints. Preclinical studies suggest that FXR- and PPAR-agonists, inhibitors of the apical sodium-dependent bile salt transporter (ASBT-inhibitors) and the C23 UDCA derivative nor-UDCA are promising agents for the treatment of primary sclerosing cholangitis (PSC)...
January 9, 2018: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29310376/perioperative-analgesia-after-intrathecal-fentanyl-and-morphine-or-morphine-alone-for-cesarean-section-a-randomized-controlled-study
#19
Wojciech Weigl, Andrzej Bieryło, Monika Wielgus, Świetlana Krzemień-Wiczyńska, Marcin Kołacz, Michał J Dąbrowski
OBJECTIVES: Intrathecal morphine is used in the postoperative management of pain after caesarean section (CS), but might not be optimal for intraoperative analgesia. We hypothesized that intrathecal fentanyl could supplement intraoperative analgesia when added to a local anesthetic and morphine without affecting management of postoperative pain. METHODS: This prospective, randomized, double-blind, parallel-group study included 60 parturients scheduled for elective CS...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29308212/-the-efficacy-of-extracorporeal-liver-support-with-molecular-adsorbent-recirculating-system-in-severe-drug-induced-liver-injury
#20
Jaishvi Eapen, Rotimi Ayoola, Ram M Subramanian
We report a case of a 26-year-old man with no significant medical history, who presented with fatigue, pruritus, jaundice, dark urine and clay colored stool for one month. He had been taking methyl-1-etiochoenolol-epietiocholanolone, an androgenic anabolic steroid (AAS). He was initially found to have a total bilirubin (Tbili) of 6 mg/dL. He discontinued the AAS but the patients' symptoms worsened and Tbili increased to 36 mg/d. This prompted inpatient management of his drug-induced liver injury (DILI). Molecular adsorbent recirculating system (MARS) is an extracorporeal liver support system that replaces the detoxification function of the liver...
January 2018: Oxford Medical Case Reports
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